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Amber’s double CUE surgery

Our Orthopaedic Surgeon, Alan Danielski, first met playful Amber when she was referred for assessment of the lameness in her left forelimb.

Amber (left) with her little sister Jade (right).

An arthroscopy (a minimally invasive surgical procedure to assess the inside of a joint) of Amber’s elbow joints revealed there was severe damage to the cartilage in both of her elbows.

Image taken of Amber’s right elbow using arthroscopy prior to her second surgery. The areas of pink are the bare bone under the cartilage. This means the cartilage on the top of the bone has completely gone. A loose bone fragment (which is white, and covered in cartilage) is also visible.

This damage is caused by bone incongruency (when the bones of the elbow joint do not fit together properly), which is part of a condition called elbow dysplasia. As the damage in Amber’s left elbow was more extensive, and she was not exhibiting major lameness in her right forelimb, the decision was made to perform Canine Unicompartmental Elbow (CUE) surgery on her left elbow. Amber’s surgery went well, and she was discharged home to recover alongside her family. 

Amber during recovery after CUE surgery on her left elbow.

During Amber’s recovery, her carer noticed that she was now starting to limp on her right forelimb. Therefore six months later, Amber returned to see Alan for a second CUE surgery, this time on her right forelimb. 

Post-operative X-Ray of Amber’s right elbow following her second surgery showing the CUE implants.

Amber recovered very well, and now, a further eight months post-surgery she is happily running around pain-free. As a lovely girl of 11-years old, and with her elbows having been in such a damaged state, it is heartwarming to see how these surgeries have brought her another lease of life. 


Arthritis is almost always the consequence of an orthopaedic condition or pathology affecting a specific joint. As Amber has demonstrated, it is possible to treat the joint and improve our pet’s quality of life. Our Orthopaedic Surgeons, Alan and Stefano, have extensive knowledge and experience of treating elbow problems. They are always happy to provide advice to veterinary professionals on orthopaedic conditions, and the available treatment options which can enhance your patient’s quality of life.

If you are a carer and concerned about your pet’s joints please talk to your local vet in the first instance. As a referral centre, we can only take referrals from veterinary professionals.  

For more details about our Orthopaedic Surgery Service visit here.

About elbow dysplasia

Elbow dysplasia is a common cause of forelimb lameness in dogs. It results from the abnormal growth of the bones in the elbow joint and can lead to severe damage to the cartilage. This damage to the cartilage causes pain, swelling and ultimately severe arthritis in the elbow joints, resulting in limping and lameness in the forelimbs.  

If your dog is suffering from this condition, you may observe changes in their usual activity levels and differences in their behaviour. 

Treatment of elbow dysplasia 

Treatments for elbow dysplasia include oral medications, joint injections, physical therapy, and surgery. 

About CUE surgery

The Ralph is one of only a few centres in the UK equipped to offer CUE surgery to patients with severe cartilage damage and arthritis progression.

CUE surgery involves partial resurfacing of the elbow joint using special implants. The implants prevent the bones from grinding against one another, thereby protecting the cartilage, preventing further collapse of the joint and eliminating the pain and lameness. This technique is considered to be a “partial elbow replacement” but it carries far better results and none of the catastrophic complications related to total elbow replacement. On average, recovery tends to be uneventful, with progressive improvement and lameness resolution peaking six months post-surgery.

Thank you for taking the time to read Amber’s story. Stay tuned for more stories from the hospital.

Keep safe and take care,

Team Ralph

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