Canine Unicompartmental Elbow (CUE)

Elbow osteoarthritis is an extremely debilitating problem affecting many dogs. It can affect dogs as young as 12 months of age all the way through to seniors. The underlying cause is often elbow dysplasia, of which there can be multiple contributing factors, including medial coronoid fragmentation, elbow incongruity, united anconeal process, and osteocondrosis dessicans (OCD).

Young dogs are often treated with arthroscopy; however, historically, there have been very few surgical options for dogs with advanced elbow osteoarthritis. Many dogs are reliant on daily pain medication (often non-steroidal anti-inflammatories), supplements, and/or joint injections. Other dogs learn to just live with the pain of advanced osteoarthritis.

Arthroscopy of arthritic joints frequently reveals bone on bone contact with full loss of the articular cartilage layer. In many cases, there are fragments of bone (osteophytes) floating within the joint. In a large number of dogs, cartilage loss is concentrated on the inner half (medial) compartment of the elbow.

With this is mind, Dr. James Cook (University of Missouri), Dr. Kurt Schultz, and Josh Karnes developed the canine unicompartmental elbow (CUE) replacement in 2005. Arthrex, an orthopedic medical device company, has been intricately involved in the design, manufacture, and distribution of the implant. The principle goal of the procedure is to eliminate bone on bone contact (and therefore remove pain) by providing a bearing surface, while maintaining the natural stabilizers of the elbow. Secondary goals included safety, and a simple, repeatable technique at an acceptable cost.

The implant is small, yet provides continuous implant contact through a range of motion.

Some frequently asked questions are below:

Is my dog a candidate?
Your surgeon will perform a thorough evaluation of the elbow before making a recommendation for surgery. He/she may order specific tests to determine if your pet is a candidate for the CUE procedure, including X-rays, CT scan, and/or arthroscopy.

How long does it take to recover from the surgery?
Your pet is expected to return home the next day and be able to move around within the first week. Activity restrictions are maintained for 6-8 weeks. It is expected that your pet will achieve pre-surgical function (or better) 6-8 weeks after surgery. Peak performance is not expected to occur until 6 months after surgery. Some dogs are even able to return to high-level activity that was not possible prior to the surgery (see video below).

How long does the surgery take?
The surgical implantation takes approximately 1 hour to perform.

What are the risks of surgery?
Potential risks include infection, implant complications, fractures, and persistent lameness.

Where can I get more information?
Please see the following links for more information:

Produced by Arthrex, this client-focused brochure helps to explain CUE further.

Watch this video where Dr. James Cook explains the outcomes/results of the CUE in detail.