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SAS scs RUSVM > Final: Hip, Stifle > Flashcards

Final: Hip, Stifle Flashcards

1
Q

What is the surgical option for puppies <20 weeks old with hip dysplasia?

A

Juvenile pubic symphysiodesis

Close part of growth plate to get more coverage of acetabulum

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2
Q

How much drawer is normal in an adult dog? Puppy?

A

Adult= NONE

Puppy = 4-5mm but with abrupt stop at cranial extent

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3
Q

T/F: Most dogs outlive their orthropedic impants.

A

True

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4
Q

Are lateral patellar luxations more common in small or large breed dog?

A

Large

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5
Q

What are the functions of the collateral stifle ligaments?

A

Provide joint stability medially and laterally

Prevent varus-valgus motion

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6
Q

Which of these is the cranial and which is the caudal cruciate ligament? Which ligament is torn?

A

Red= Caudal

Blue= Cranial

Torn Cranial, should be same width as caudal

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7
Q

What makes the cranial drawer sign limited or ‘constrained’ in a chronic case of CCL rupture?

A

Scar tissue /fibrosis

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8
Q

When is the highest risk of dislocation post THR?

A

First 2 weeks post-op

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9
Q

How long after an extracapsular repair do you expect a return to peak function?

A

6 months

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10
Q

Why do you do rads when you have a CCL rupture?

A

To rule out other injuries and visualize joint effusion (medial butress)

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11
Q

What surgery is indicated for Legg-Perthes disease?

A

FHO (asap)

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12
Q

What is the ‘Common Triad’ of multiple ligament injuries?

A

Cranial and Caudal cruciate

Collateral ligaments

Medial meniscus

Deranged stifle

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13
Q

When is surgery indicated for a grade II MPL?

A

Young dog, open growth plates

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14
Q

What is used to assess joint laxity in immature dogs with early stages of hip dysplasia?

A

Ortolani sign

Only do on dogs <2yrs old

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15
Q

What are 3 indications for an open hip reduction?

A

Avulsion of fovea capitis

Closed reduction unsuccessful

Unable to maintain closed reduction

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16
Q

If you are replacing the removed portion of the patellar groove what type of trochleoplasty have you performed?

A

Recession (block or wedge)

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17
Q

What does a positive cranial tibial thrust indicate?

A

Cranial subluxation of the tibia/ Completely torn ligament

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18
Q

What makes up the ‘triangle’ of structures you palpate or see on rads to ensure proper hip placement?

A

Tuber ischii

Crest of ileum

Greater trochanter

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19
Q

How many grades of patellar luxation are there?

A

4

(1-4)

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20
Q

What part of the meniscus is often injured when CCL rupture occurs? Why?

A

Caudal body of medial meniscus

CCL rupture displaces medial femoral condyle caudally in flexion leading to wedging/crushing when limb is extended or bares weight

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21
Q

Lateral patellar luxation is often associated with coxa ____.

A

Valga

Knock-kneed

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22
Q

What type of bandgae do you need to place post closed hip reduction? For how long?

A

Ehmer sling

7-10 days

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23
Q

Why is surgery recommended for most dogs with CCL insufficiency?

A

Need to establish joint stability

To less secondary DJD

To address any concurrent meniscal injury (which is painful)

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24
Q

What is the most common congential deformity in dgos? What is the typical signalment and presentation?

A

Medial patellar luxation

Small/Toy breed dog

Bilateral

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25
Q

What is a surgical procedure you can do for a 5-8 month of dog with hip dysplasia and without evidence of DJD? What angle of reduction provides the most favorable prognosis?

A

Triple Pelvic Osteotomy (TPO)

Improves dorsal coverage of head of femur by axially rotating and lateralizing the acetabulum

<30 deg

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26
Q

If you feel joint effusion in the stifle in a dog with a CCL tear is it more likely acute or chronic?

A

Acute

27
Q

T/F: Lameness with MPL is always associated with the grade.

A

False

28
Q

Where is suture passed for the extracapsular lateral suture technique of reconstruction of the CCL?

A

Through deep facia around flabella and through predrilled hole in tibial crest

29
Q

What is the most common surgical management technique for a meniscal tear?

A

Partial menisectomy

30
Q

What is the typical signalment for a dog with Legg-Perthes disease?

A

Young (6-7 mo)

Toy or Small breed dog

Usually unilateral

Progressive weight baring lameness

Pain (irritability, inappetence, chewing at skin over hip)

31
Q

What are the medical management options for a puppy showing signs of hip laxity?

A

Reduce food intake (low fat and protein)

Keep dog lean

Do not supplement diet (esp w/Ca)

Maintain strength and joint motion - use NSAIDs, passive exercises, glucosamine…

32
Q

What is the first sign of hip displasia?

A

Joint laxity

33
Q

The lateral suture and tightrope technique are passive constrain methods of CCL fixation. What type of method is TPLO?

A

Active/dynamic constraint

34
Q

If you feel crepitus when doing a ROM test on a dog post-FHO, what does it indicate?

A

You left a shelf of bone caudally (did not remove enough of the neck)

35
Q

What is an imbrication?

A

Tightening

36
Q

What type of suture is indicated for extracapsular CCL repair?

A

Monofilament nylon fishing line

(#6 Nylon is tested to 40-100lbs)

37
Q

Why is a craniodorsal luxation of the hip most common?

A

Middle and deep gluteal muscles insert on the greater trochanter and originate on the pelvis so the femor gets pulled cranially and dorsally

38
Q

T/F: A dog should be put under general anesthesia for a closed hip reduction.

A

True

39
Q

If during a physical exam you are trying to luxate the patella medially, the leg should be held in _____ and the leg should be rotated ______.

A

Flexion

Internally

40
Q

What is your plan of action if there are no radiographic changes but all of the clinical signs point to a cruciate ligament tear?

A

Joint tap

41
Q

What is an important ddx for collateral ligament injury?

A

Fracture of the condyle

42
Q

If the craniomedial band of the CCL tears but the caudolateral band remains intact, when will you see a cranial drawer sign?

A

In flexion

43
Q

What are the options for reconstruction of the hip?

A

Capsulorraphy

Translocation of greater trochanter

44
Q

Medial luxation of the patella causes ____ bowing of the distal third of the _____.

A

Lateral

Femur

45
Q

Which bands of the CCL is taut in extension only and which is taut in all phases?

A

Caudolateral= taut in extension

Craniomedial= taut in flexion and extension

46
Q

What approach do you take to the joint during an FHO?

A

Craniolateral

47
Q

What is the most common type of meniscal tear?

A

Caudal bucket handle tear

48
Q

Which type of THR has a higher risk of loosening and infection? Which one has a higher risk failing to ingrow?

A

Cemented

Cementless

49
Q

What complication following THR requires removal of the impant? What surgery must follow?

A

Infection

FHO

50
Q

Is this gait/stance/posture more characteristic of early or later stage hip dysplasia

A

Early

Due to acute pain- weight is shifted forward to take weight off the rear limbs

51
Q

What CCL procedure eliminates cranial tibial thrust but not the cranial drawer sign? What angle between the tibial plateau and the patella is needed to eliminate thrust?

A

Tibial Tuberocity Advancement (TTA)

90deg

52
Q

What are the prosthetic implant options for hip repair?

A

Prosthetic capsule made of sututre

Toggle pin

53
Q

What is a prerequisite for TPLO?

A

Intact caudal cruciate ligament

54
Q

What is the most commonly luxated joint in dogs and cats?

A

Coxofemoral joint

55
Q

What is the noninflammatory aseptic necrosis of the femoral head that occurs in young patients before the closure of the capital femoral physis?

A

Legg-Perthes Disease

56
Q

T/F: You should rule out growing pains as a cause of hip laxity before diagnosing hip dysplasia.

A

False, not a real thing

Pain is caused by the stretching of the joint capsule due to laxity

57
Q

What are the radiographic signs seen with Legg-Perthes disease?

A

Deformity of femoral head (moth eaten, lucency)

Shortening and thickening of femoral head

Foci of bone opacity in epiphysis

May not see changes even if disease is present, important to repeat rads in a month is suspect disease (Or do CT)

58
Q

What distraction index value indicates hip dysplasia? For what method of diagnosis is this from?

A

>/= 0.3

Penn-Hip method (distraction/stress radiography)

0= no subluxation at all, 1= complete luxation

59
Q

What is the typical gait for a dog with patellar luxation under grade V?

A

Skipping gait

60
Q

What are the 2 surgical options for hip dysplasia in mature dogs?

A

Total Hip Replacement (THR)

Replacing acetabulum, femoral head and neck- better for large active dogs

Femoral Head and neck Ostectomy (FHO)

Best before skeletal maturity

61
Q

T/F: Early neutering is a significant risk factor dor excess TPA, which can predispose to CCL rupture.

A

True

62
Q

Dogs affected with hip dysplasia have a disproportionately rapid _____ growth and a relatively delayed ______ growth.

A

Skeletal

Muscle

63
Q

When performing the Ortolani test, the greater tha angle of ____ the greater the degree of laxity.

A

Reduction

64
Q

What other reconstruction technique, in addition to the lateral suture technique, involves using suture to mimic the path of the CCL?

A

TightRope CCL

SAS scs RUSVM (24 decks)

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