Arthrology Flashcards
What are the zones of articular cartilage?
Superficial zone (contact zone between surfaces) - lamina splendens, gliding zone & boundary layer of protein material. (this is the zone lost when you lose cartilage). Transitional zone Radial zone Tide mark (thin wavy blue line) Calcified zone
Where is the majority of fluid in the joint?
Medial side
Which part of the joint has blood and nerve supply?
Capsule
What occurs with aging of cartilage?
Get necrosis from the deep subchondral bone being deprived of oxygen.
What occurs with deep penetrating injury?
Defects fill with blood and you get a big clot and repairs with woven bone.
How does movement affect cartilage recovery?
The more movement of cartilage the quicker the recovery. Want continuous passive recovery (mimic the normal movement of joint).
If there is no movement you get cartilage degeneration.
What is osteochondritis dissecans?
Inflammation of the shoulder joint usually in large-medium breed dogs, more males.
Get a short swing phase, shifting lameness and shoulder extension.
How do you diagnose, treat and post op osteochondritis dissecans?
Diagnosis - loss of density top right humerus (radiography)
Treatment- NSAIDS, cage rest (for 6 weeks try this first). Then do arthroscopy!!! - this avoids nerve damage.
Post op - quick discharge, limit activity, seroma formation.
Which is worse medial or lateral shoulder luxation?
Medial. It ALWAYS needs surgery because the small collateral ligaments stretch very easily and tear. Just pop a lateral luxation back in and spica splint.
What is omarthrosis?
Degenerative joint disease of a joint.
Explain finding a lytic part in the cartilage of a humerus of a puppy.
Occurs in fast growing puppies where the cartilage gets cut off and breaks off - floating around inside joint causing lots of pain.
What is osteochondrosis?
Abnormal articular cartilage differentiation - failure of endochondral ossification.
Get vertical fissures.
How does elbow dysplasia occur?
Dog grows too much and ulna doesn’t grow fast enough can’t keep up to the radius.
Identify based on MRI or CT.
Usually more in Rottweilers and Labradors.
Involves fragmented medial coronoid process, osteochondrosis, ununited anconeal process and elbow incongruity.
What is and how would you deal with a fragmented medial coronoid process?
Get joint instability and cartilage erosion and osteophytes.
Mostly 5-8 months old.
ALWAYS do the surgery and remove the FMCP. Surgery won’t always stop DJD just extends the process of not getting it for awhile *
Ununited anconceal process arises after ______ ossification at __to ___ weeks old.
Secondary ossification at 11-12 weeks old.
How do you get ununited anconeal process and describe what you will see and how you will treat it?
From asynchronous growth of radius & ulna & humeral trochear rim.
Get no fusion and joint effusion.
Test by pulling leg forward.
Treat conservative then surgery after 5 months
What are the main causes of hip luxation and in what aspect of the hip do they mostly occur?
Trauma, injury or spontaneous.
90% are craniodorsal, 10% ventrocaudoventral.
What is affected anatomically by hip luxation?
Ligament capitis femoris tears
Joint capusle tears
Gluteal muscles can tear
Can get avulsion fracture of femoral head
How do you diagnose hip luxation?
History of trauma.
Always sedate before pulling any limbs! *
Adduction & rotate limb, paw beneath the body, tarsus rotate in, stifle rotate outwards.
The affected limb will be shorter in a craniodorsal presentation.
Do the THUMB TEST! Push on trochanter major and tuber ischia if your finger is pushed out the dog is normal. If not you have a luxated hip.
Do radiographs.
When do you use the thumb test?
To diagnose hip luxation
Which of the following is a good treatment for hip luxation? Articular cartilage nutrition Reduction Capsulorrhaphy Trans-acetabular pinning Femur head & neck excision
ALL! But Japie likes to do a deep gluteal tenodesis.
What is hip dysplasia? * Final exam*
Abnormal hip joint development of acetabulum and femur head.
All dogs born with normal hips then this develops the joint capsule stretches until it can’t keep the femur in the acetabulum.
What are some secondary manifestations of hip dysplasia?
Joint capsule laxity, joint effusion, osteophytes form, acetabulum filling, damage to dorsal acetabular rim.
What is the pathogenesis of hip dysplasia?
Large giant breed dogs.
Shallow acetabulum
Short femur neck/anteversion of femur neck.
*So acetabulum too short or femur head malformed.
Related to growth - diet, aggressive eats, fat.
What’s the best methods to prevent hip dysplasia?
Confine.
Sitting on haunches.
Swimming rather than walking.
How do you diagnose hip dysplasia?
Clinical exam and radiography.
What are the 4 objectives to hip dysplasia treatment?**
Reduce joint pain
Establish normal gait
Protect cartilage
Limit OA/DJD development
How are you going to medically and surgically treat hip dysplasia?
Medical - NSAIDs, chondroprotectants, weight resitriction, restricted exercise, confinement
Surgical - juvenile pubic symphysiodesis (burn growth plate to completely reduce pain), denerve hip joint, femur head & neck excision, triple pelvic osteotomy, total hip replacement, acetabuloplasty.
What is the Ortolani sign?
In diagnosis of hip dysplasia. Abduct the leg of dog in dorsal recumbency and you look at the angle of reduction/subluxation.
Describe the cruciate ligament.
Stabilises the knee joint.
Two bodies - cranial part & two caudal parts
Describe the kinesiology of the stifle.
Rolling motion of femoral condyles and the cruciate ligaments twist limiting tibia rotation.
Medial meniscus of stifle joint attaches to medial collateral ligament (why meniscus tears easily).
Meniscus slides cranially with femoral condyles in extension*
How does the meniscus move and alter during stifle movement?**
Flexion - menisci slides caudally
Extension - menisci slides cranially
Medial meniscus attached to medial collateral ligament. Lateral meniscus is unattached.
What are the four ligaments of the stifle joint?
Collateral
Patellar
Menisco-femoral
Cruciate
What are the clinical signs of a ruptured cruciate ligamnet?
Sudden onset hindlimb lameness
Toe touching & atrophy & fibrosis
Clicking when dog walks
Crepitation palpable on flexion & extension
Osteophyte forms
*ALWAYS anaesthetise before you feel stifle
How do you diagnose a cruciate rupture?
Cranial drawer sign
-Push on the stifle either sides with your thumb if it is laxed it is positive
Also radiograph
How would you treat a ruptured cruciate?
What’s your treatment of choice for meniscal injuries?
Partial meniscectomy and maybe osteophyte removal.
Where is the meniscus most likely to tear and why?
Medial meniscus more likely because medial ligament is attached to it.
Why does patellar luxation occur?
From femur anatomy, hip dysplasia or tibia anatomy. Can be a complication of cruciate rupture.
Medial is more common because of the muscles pulling.
What’s your treatment choices for patella luxation?
Anti-rotational suture Medial desmotomy Imbrication lateral retinaculum Lateral transpositioning of tibial tuberosity Wedge/block recession trochleoplasty
How do you diagnose a tibiotarsal joint luxation?*
Radiograph tarsus with stress views to see which collateral ligaments are deficient
