Elbow joint. Frequently Asked Questions
What is certification of veterinary surgeons offered by BioMedtrix, USA?
The company sells joint implants and prosthetic systems exclusively to certified veterinary orthopedists and animal clinics. Certification program is available to any veterinary orthopedist that completed the training in BioMedtrix. Candidates certified by BioMedtrix demonstrate understanding of items necessary for successful clinical outcomes. The company provides certification for total hip replacement in dogs and cats, total knee and elbow replacement in dogs.
How BioMedtrix, USA works and certifies veterinary surgeons to perform total joint replacement in dogs and cats?
BioMedtrix company is a manufacturer and supplier of joint prostheses for dogs and cats, as well as the system for such kinds of procedures. Manufacturing processes comply to ISO 13485.
Company offers training for veterinary surgeons followed by certification, and provides working tools and joints only upon completion thereof. If veterinary surgeon does not perform any joint replacement surgeries for 3 years, certificate is revoked, and the surgeon, if desired, may undergo proficiency testing once again and get a new certificate.
BioMedtrix company was founded in 1998 in USA with the objective of designing, developing, and manufacturing state-of-the-art veterinary orthopedic implants. Company mission is to provide quality in all aspects of joint prosthetic system development, manufacturing, and service. BioMedtrix is cooperating with word leading veterinary surgeons and continuously developing new programs in order to meet the needs of veterinary orthopedists. BioMedtrix is represented in over 95% of the US veterinary universities, selected international universities, and specialty clinics throughout the world. The company has over 400 partners – certified veterinary surgeons specializing in orthopedics and joint replacement surgery, which have been using BioMedtrix products with over 20 years of clinical success. This high level of support from our customers provides the company the opportunity to continue orthopedic product development.
Under BioMedtrix operational policies, quality standards comparable to those used by human orthopedic manufacturers are maintained. The company adheres to all ASTM specifications for implant materials and maintains standards for articulating surfaces of implants which meet or exceed those specified for human implants. Manufacturing processes comply with ISO 13485 that specifies requirements for a quality management system for medical devices.
How long does BioMedtrix, USA exist and what activities is carrying out?
The company has been in the business for more then 30 years; it develops and produces joint implants for dogs and cats that are successfully used in clinical practice by more than 500 certified veterinary orthopedists all around the world.
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How long will my dog be in the hospital following TER surgery?
Most veterinarians keep dogs for one to three days following surgery. In some rare instances, high-risk patients may be hospitalized for longer periods to provide additional assistance or to protect the stability of the new prosthetic joint.
How is the total elbow replacement procedure performed in the clinic?
Patients are screened before surgery to make sure they do not have problems in other joints of the affected front limb such as the carpus (wrist) or the shoulder. Your veterinary surgeon will also ensure that your dog is healthy, does not have any neurological or medical conditions including chronic infection such as pyoderma.
Once preoperative examinations are completed, radiographs (x-rays) are taken to assess the severity of the elbow problem. If TER is indicated, surgery can be scheduled.
The surgery entails the removal of the damaged articular surface of the humerus, ulna and radius at the elbow.
If surgery is deemed necessary, an anesthesiologist’s consultation is needed in order to schedule a pre-surgery evaluation. If no contraindications to general anesthesia exist, the date of surgery is scheduled. The owner is requested to wash the dog just before the surgery, and to start giving antibiotics. The dog is to be admitted to the clinic and stay in our in-patient unit for the whole period of surgery and post-operative observation. Duration of in-hospital stay rarely exceeds 7 days. After discharge we will monitor the implant condition by X-ray on days 14, 30, 60, and then 6 months after surgery; thereafter, follow-up orthopedic exams are performed yearly.
How to make a right decision pro or contra total joint replacement?
Total joint replacement is not an urgent surgery, so decision should be balanced and based on specialist advice.
How do I know that my dog needs joint replacement?
Failure of medical treatment and irreversible joint damage.
Is it possible to manage joint diseases without joint replacement?
Most orthopedic diseases can be successfully managed without prosthetic repair.
How do I know that my dog has a joint problem and needs to be examined by veterinary orthopedist?
Gait disturbances, rapid fatigue and reluctance to move as it normally would, for example to jump or walk upstairs, are all the obvious signs of an orthopedic problem.
Is it possible and necessary to replace a joint at an early stage of progressive joint disease?
No; joint sparing treatment to the fullest extent possible should be attempted.
Is total joint replacement a last-resort option, when other treatment methods have failed, or a treatment option for joint disease?
Yes, it is a last-resort option, when salvage of native joint is unfeasible, and conservative treatment is ineffective.
Are there reasons why my dog shouldn't have a TER?
TER is not performed on dogs with cancer or other major medical problems of higher priority for treatment. Dogs with lameness caused by problems other than elbow pain, including problems affecting the neck, shoulder, carpus, or metacarpals must be carefully evaluated before a TER is performed. Severely overweight dogs should enter a weight management program prior to surgery.
What are the risks of TER?
TER, like all surgeries, carries a low risk of anesthetic and infection complications. Additional risks include fractures fo the ulna or humerus. These complications, while serious, are limited. Anecdotal reports suggest that the current rate of severe complications with the TATE is less than 7% up to 4 years after surgery.
What are the alternatives to TER?
Medical management of elbow dysplasia can include optimization of the patient’s body weight, administration of non-steroidal anti-inflammatory drugs (NSAIDs), nutritional supplementation, and implementation of a rehabilitation program.
End stage elbow dysplasia is often an intractable disease. This means that alternatives, such as medical pain management or conventional surgical procedures, have failed and are no longer effective. At that late stage, surgical fusion of the joint (arthrodesis) or amputation of the limb may be last resort options. However, these may be ill-advised when, as it is most often the case, both elbows are arthritic. Fusion of the joint involves the surgical removal of any tissues that may inhibit the joint’s ability to fuse and the application of an internal or external device to lock the joint at a predefined angle. This will cause the bones to grow together resulting in a fused joint. Fusion will likely remove the pain associated with the joint but will likely lead to an abnormal gait as the elbow joint will no longer exist. Amputation is an option if the disease is occurring in only one of the elbow.
What does TER surgery entail?
Patients are screened before surgery to make sure they do not have problems in other joints of the affected front limb such as the carpus (wrist) or the shoulder. Your veterinary surgeon will also ensure that your dog is healthy, does not have any neurological or medical conditions including chronic infection such as pyoderma. Once preoperative examinations are completed, radiographs (x-rays) are taken to assess the severity of the elbow problem. If TER is indicated, surgery can be scheduled.
The surgery entails the removal of the damaged articular surface of the humerus, ulna and radius at the elbow.
What are the clinical signs of elbow dysplasia?
Signs of elbow dysplasia may be subtle early in the disease’s progression, but become much clearer as it develops. Early on, they can include a subtle limp after a bout of exercise. As the disease progresses, dogs generally become less active and playful, choosing to lie down more often in an effort to take the weight off their elbows. At a level described as “end stage,” a dog may be reluctant to get up and walk a short distance. At this stage, joint manipulation is usually quite painful and the range of motion of the elbow is considerably limited.
What is elbow dysplasia?
Elbow dysplasia is an abnormal condition involving multiple developmental abnormalities of the elbow joint. These abnormalities initially induce localized lesions where the healthy joint cartilage surfaces are eroded. This degenerative process further deteriorates until the articular cartilage has all but disappeared thus resulting in painful direct bone-on-bone contact. Eventually, elbow dysplasia affects the entire joint and is characterized by a limited range of motion as a result of periarticular fibrosis, pain and a proliferation of bone spurs around the joint. Ultimately, this leads to a loss of overall limb use due to pain and joint function. Once this process has begun, there is little that can be done to inhibit its development.
Why has a TER been recommended for my dog?
TER has been recommended for your dog to alleviate the pain and/or disability associated with end stage elbow osteoarthritis. Your dog has likely undergone other techniques intended to reduce the pain and suffering associated with elbow dysplasia. Your veterinary surgeon is recommending a TER as previous procedures have had little to no success.
What is the TATE Elbow®?
Canine total elbow replacement (TER) is a surgical procedure in which the arthritic elbow joint is replaced by a prosthetic. Unlike most prosthesis, which use stemmed cemented components, the TATE is a resurfacing prosthesis and, as such, requires a less invasive surgical technique for implantation. The prosthesis is designed to replicate the joint articular surfaces accurately after these have been carefully removed. The purpose of the TATE procedure is to mimic the fundamental motions of the elbow and eliminate the pain associated with end stage osteoarthritis of the joint.
What are indications for total elbow replacement in dogs?
Total elbow replacement is carried out in patients with elbow arthrosis, which is, in its turn, is due to elbow dysplasia. When arthrosis is steadily progressing and leads to inability to walk without pain, total elbow replacement is the only alternative to continuous use of painkillers.
Total elbow replacement (TER) in dogs is the only treatment option to restore range of movement in elbow arthrosis patients with lifelong benefits.