Arthritis comes in many forms and can affect any joint from the largest to the smallest. Most commonly in pets we see arthritis being particularly problematic in the large limb joints – the hips, knees and elbows. It can also affect smaller joints like the temporo-mandibular joint (jaw joint), back bones and the small bones of the paws and toes.

Recently, I saw a young Dalmatian who had developed a painfully arthritic toe, which had previously been broken in an accident. As a result of this old trauma, the joint between the toe bones and the metatarsals (bones of the foot) had become very swollen and painful for this energetic young dog. Pain relief and anti-inflammatory medication helped but didn’t seem like a great long-term solution for this young patient.

One option would have been to amputate the offending toe; another was to try to fuse the joint so that it became less mobile and hence less painful (a procedure called an arthrodesis), but this would take a long time to heal and require an extended period of strict rest and dressings.
In the end, we opted for a third option called an excision arthroplasty. This procedure removes the articulating surfaces of the joint, essentially amputating a small piece of bone and cartilage on either side of the joint. This leaves a gap where the joint had been, which eventually fills in with fibrous scar tissue.

A quick resolution of the pain

The advantage of this procedure is a quick resolution of the pain from the arthritis without needing to amputate the whole toe. Although there is a gap where the joint previously was, the toe looks very normal and because the soft tissue structures (ligaments/muscles/skin) are all still present, the toe can still work relatively normally.

In fact, the most common joint that an excision arthroplasty is performed on is the hip joint in cats and small dogs. It is usually performed on a fractured or dislocated hip that is unlikely to heal well on its own. It works surprisingly well, with most patients returning to normal, pain-free limb function. In this case our young Dalmatian patient is back to running around without the need of painkillers and with all toes still present and accounted for!