Common Injuries and Sports Medicine in Companion Animals Flashcards
What history questions should you ask for canine athletes
- Age at which they started training: Higher risk of injury with high impact/repetitive training before maturity
- Gonadectomy Status: Predisposed to orthopedic injury if neutered before reaching puberty
- Activity Level: How often and how long are they training
- Diet/Supplements
Low impact activities
Rally and conformation
Common injuries in Agility
Soft tissue injuries – shoulder, iliopsoas strains and CCL
Common injuries in obedience
Shoulders – usually the left due to chronic uneven weight distribution, head always looks
to right at the owner
Common injuries in Flyball
Chronic repetitive stress injuries – shoulder, carpus, iliopsoas, MSS, hip arthritis
Common injuries Dock diving
Back pain and hips
Common injuries in Feild trials/ hunt trials
Feet, carpus and shoulders, arthritis, carpal hyperextension
Common injuries in working dogs
Mainly related to overuse and repetitive stress or trauma
Common Conditions and Surgical Interventions (Hip)
- Femoral Head and Neck Ostectomy (FHO)
- Total Hip Replacement (THR)
Common Conditions and Surgical Interventions (stifle)
- Extracapsular Suture Repair
- Tibial Plateau Leveling Osteotomy (TPLO)
- Tibial Tuberosity Advancement (TTA)
- Tibial Tuberosity Transposition (TTT)
- Patella Groove Replacement (PGR)
Femoral Head and Neck Ostectomy (FHO)
Salvage procedure, excision arthroplasty – femoral head and neck are removed
* Creates a pseudoarthrosis (false joint) –
formed from fibrous tissue
* Treatment – severe OA, irreparable fracture
involving the joint, severe/recurrent joint
luxation, or congenital joint deformities
* Complications – incorrect ostectomy (bone-
on-bone contact)
FHO Prognosis
- Good
- Patients can return to daily function, however normal gait and function are not achieved due to biomechanical changes
- Specifically hip extension remains limited – patient will be able to walk and trot mostly normal
- Functional shortening of the limb is expected and slight gait
abnormality - More difficult recovery process for larger patients
FHO rehab considerations
Control Pain:
* Usually need NSAIDs longer than most post-
operative patients, during entire recovery period (up to 3 months)
* Consider Gabapentin
Maintain range of motion
* Need to start immediately to prevent too much fibrosis
* Active stretching exercises AROM, PROM, stretching
When should you start rehab for an FHO
Immediately
Total Hip Replacement (THR)
- Salvage procedure – femoral head is removed and replaced
with a femoral prosthesis and the acetabulum is replaced
with a prosthetic acetabular cup - Eliminates the joint therefore eliminating joint-associated
pain - Treatment – severe OA
- Complications – luxation, infection, fracture, implant
failure/loosening - Prognosis: Very Good to Excellent
Total Hip rehab considerations
Prevent post-surgical luxation and promote tissue regeneration
- Hip dislocation is the most common complication
- Extreme care should be used up to 3 months post-operative
- CAUTION with rehabilitation – no Abduction/Adduction, leg should ONLY move in a sagittal plane
- Owner education important – some surgeons do not even instruct owners to perform PROM at home bc of this
What can’t you do in rehab with a total hip
no Abduction/Adduction, leg should ONLY move in a sagittal plane
Luxation can happen up to _________ post of from a total hip
3 months
THR-Rehab limb function
Week 2-10: Limb placement
* Early limb use can be encouraged with gentle weight shifting exercises
* Mandatory slow leash walks ONLY starting with 5 minutes
Week 10-12: begin limb strengthening
* Usually do not begin until recheck radiographs are taken and surgeon clears the patient for re-introduction
Menisci
- Between condyles of femur and tibia
- Medial meniscus - connected to tibia and medial collateral ligament
- Lateral meniscus – connected to tibia, allowing for higher range of motion
Cranial cruciate ligament
prevents “cranial drawer” or cranial displacement of tibia and internal rotation of tibia towards the femur
Caudal cruciate ligament
prevents “caudal drawer” or caudal displacement of tibia toward femur
Lateral Fabellar Suture (LFS)
- Extracapsular stabilization technique – use
of heavy gauge synthetic suture is wrapped
around the lateral Fabella and through a pre-drilled hole in the proximal tibia in a
figure-8 pattern - prevents cranial displacement of the tibia
- Scar tissue will eventually form over the joint for long-term stabilization
Prognosis is good
Lateral Fabellar Suture (LFS) Rehab considerations
- Control Inflammation
- TENS and massage to reduce edema
- Control Pain
- Improve range of motion
- PROM should start on Day 1
- Therapeutic U/S
Lateral Fabellar Suture (LFS) Rehab Limb ROM and Function
Day 1: begin PROM immediately
Week 2: add in gentle passive stretching, UWTM intro
* Avoid extreme flexion and extension
Week 4-5: add in more active range of motion
* Cavaletti poles
* Continue to avoid extreme flexion and extension
* No stair climbing until week 5-6
When can LFS patients climb stairs?
not until week 5/6
TPLO and TTA Rehabilitation
Both techniques are osteotomy procedures that alter the
biomechanics of the joint in order to provide dynamic
stabilization
* Rehabilitation is similar to Extracapsular Repair with some precautions
* Can begin UWTM as early as 2 weeks post-op
TPLO and TTA Prognosis
- Good to excellent
- Return to full function
TPLO and TTA Rehab considerations
- Caution: Avoid TENS or Laser directly over the plate
- Avoid extreme flexion/extension until Week 6
- Until Week 8-10: Avoid increased loading exercises until radiographs show appropriate bone healing and surgeon releases to increase activity
- Patient should NOT be walking any longer than 20 minutes 2x/day until recheck radiographs
Patella luxation repair
Tibial Tuberosity Transposition and trochlear wedge
recession (TTT)
* Surgical correction to deepen the patella groove and
change the position of the tibia in order to correct the
tracking of the patella ligament over the patella groove
TTT: Prognosis
Prognosis:
* Long-term success is varied
* Depends on the severity of the grade
* Often luxation reoccurs at a lesser severity
Complications:
* Implant loosening
TTT – Rehab Considerations
Improve Range of Motion
* Caution: sagittal plane only
Week 2-4: heavier limb use can begin with caution
* Avoid exercises that cause extreme flexion and
extension, explosive activity, jumping, running, active
play
Week 6-8:
* Gradually increase to higher impact activity
* Stairs, inclines, weave poles
