Hindlimb Lameness- Hip & Hock Flashcards
What predisposes an animal to Hip Dysplasia?
Genetic- polygenetic disease
also environmental influence such as diet, exercise
What is the pathophysiological process of Hip Dysplasia?
Hip joint has increased laxity- so hip starts to move away from the femoral head due to this excess flexibility
What other pathologies can Hip Dysplasia lead to? (2)
Acetabular rim microfractures
OSTEOARTHRITIS
At what age does Hip Dysplasia usually present?
6-7 months old
What are the most common clinical signs of Hip Dysplasia? (5)
Bunny hopping
Hindlimb lameness
Exercise Intolerance
Lateral pelvic swaying- animal tries to avoid using the hips
Possible muscle atrophy
In older dogs with suspected Hip Dysplasia, what other diagnosis must we eliminate first?
Cruciate Ruptures- check cranial drawer test
How do we confirm Hip Dysplasia with radiographs?
Extended leg radiograph and one of the lateral pelvis is taken
Look for the acetabulum to cover 50% of the femoral head
What are Luxoid hips?
Most severe form of Hip Dysplasia- when the femur appears ‘floating away’ from the pelvis
In older dogs, what may we also see on Radiographs that indicate long term Hip Dysplasia? (4)
Thickening and capsule mineralisation
Osteophytes/ new bone formation (ragged femoral head)
Flattening of the femoral head
Flattening of the acetabulum
What two tests can we perform on immature dogs to test Hip laxity?
Bardens test- attempt to luxate the head of the femur laterally out of the acetabulum- more than 0.5cm movement is abnormal
Ortolani Test- push down on hip and abduct it- if it pops then = hip dysplasia
What Norberg angle is indicative of Hip dysplasia?
More than 105 degrees (line between middle of the femoral head and edge of acetabulum)
What is the prognosis of dogs with Hip dysplasia without surgical management?
70% functionally doing well after 12-15 months as the joints eventually stabilise by fibrosis
What conservative management is recommended for dogs with Hip Dysplasia?
- Exercise Adjustment- regular, short term exercise
- Physical Therapies e.g. hydrotherapy & physiotherapy
- Diet- keep lean and give joint supplements that are high in omega 3 fatty acid
- NSAIDs for 4-6 weeks
What are the aims of a Pelvic Osteotomy?
Cut pelvic bone to allow rotation of the acetabulum to increase dorsal coverage and then stabilise with plate and screws
What does a juvenile pubic symphysodesis achieve?
But when is it contraindicated?
Damages the growth plate to rotate the acetabulum
Cannot be done to breeding dogs- hips too narrow for natural births
Which surgical treatment generally has the best prognosis for working dogs?
Arthroplasty- with Total Hip Replacement which then allows pseudoarthrosis (‘metal hip’ fuses with bone)
What is the better alternative to owners who cannot afford a total hip replacement?
What does it require for a good prognosis?
Femoral Head & Neck Excision- but it does require aggressive rehabilitation
How does the BVA-KC screening for Hip Dysplasia work?
When dog is older than 1 year old they can be sedated and radiographs for an extended ventrodorsal radiograph
They’re then given a score /53 per hip and the lower the score the better
What is Legg Calve Perthes and what group does this commonly affect?
avascular necrosis- blood supply to the ball part (femoral head) of the hip joint is temporarily interrupted and the bone begins to die
Effects small terriers commonly at 4 months old
How do we treat Legg Calve Perthes?
femoral head and neck excision- send it for histology and culture
What is the most common type of Hip Luxation?
Craniodorsal- femoral head is forced over the dorsal acetabulum
What should we always try prior to surgery when treating a Hip Luxation?
Closed reduction- aims to replace a dislocated hip back into the socket through manipulation of the limb without surgically exposing the joint
What common problems are associated with the Tarsus? (4)
OCD- Osteochondritis Dissecans
Achilles Degeneration/ Rupture
Plantar Ligament Collapse
[Trauma/ luxations]
What would we expect to see in a physical exam of a patient with OCD in the tarsus? (3)
Upright hocks- will stand upright to take the pressure off
Tarsal effusions or thickening
Reduced flexion and pain
Achilles tendon degenerations are more common in….
Middle aged large breeds such as Dobermans, Labradors
What is the characteristic gait of a dog with Achilles damage?
Claw or flat footed with dropped hock
How is Achilles rupture treated?
Resection & reconnection
Can use a prosthetic augmentation- artificial ligament sutured in
What is characteristic of plantar ligament degeneration/ collapse?
Banana foot
[also increased movement at intertarsal joints when manipulated]
