Ch 57 - Hip Luxation Flashcards
What are the primary hip joint stabilisers?
How many have to be damaged for luxation to occur?
Primary Stabilisers:
- Ligament of the head of the femur
- Joint capsule
- Dorsal acetabular rim
2 of 3 need to be damaged for joint luxation
What are the secondary stabilisers of the hip?
- Acetabulum labrum
- Transverse acetabular ligament
- Hydrostatic pressure
- Periarticular muscles (gluteals, iliopsoas, quadratus femoris, gemelli, internal obturator, external obturator)
What percentage of joint luxations does the hip joint account for?
90%
What percentage of hip luxations are bilateral?
- 6% in dog
- 9% in cat
What percentage of hip luxations are craniodorsal?
75%
How does a dog with craniodorsal hip lux classically hold its leg?
Externally rotated and adducted, usually NWB
In what position does an Ehmer sling hold the leg?
What is the relux rate after a closed reduction and Ehmer?
Flexes the hip, abducts and internally rotates the femur
Reluxation 15-71%
What method are available to augment a closed reduction?
- Ehmer sling
- Hobbles
- Ischioilial pinning
- ESF
- Transarticular pinning
What is the overall success rate with open reduction?
What are the available options?
Overall success 85%
- Capsulorrhaphy (83-90%)
- Prosthetic ligament technique (66-100%)
- Transposition of greater trochanter (84%)
- Transarticular pinning
- Toggle-rod (81%, relux 6-11%)
- Fascia lata loop stabilisation
- Transposition of sacrotuberous ligament
- Extra-articular iliofemoral suture
What is the recommended screw position for synthetic capsule technique?
- Left: 10 and 1 o’clock position on DAR
- Right: 11 and 2 o’clock position on DAR
List options of ventral augmentation after open reduction of ventral hip lux
- Autogenous iliac crest shelf graft
- Extracapsular sling
- Internal fixator plate to augment ventral acetabular rim
What % of dogs will have progression of OA after a hip lux?
55-62%
