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small animal surgery > Hip > Flashcards

Hip Flashcards

1
Q

What is hip dysplasia?

A

abnormal development of the coxofemoral joint

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2
Q

Describe the pathogenesis of hip dysplasia

A
  • abnormal development leads to laxity
  • capital ligament edema and thickening, increased joint fluid
  • capital ligament stretches
  • subluxation occurs with activity
  • force on the abnormal hip causes wear, which results in osteoarthritis
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3
Q

What factors contribute to expression of hip dysplasia?

A
  • genetics
  • pelvic muscle mass
  • body weight
  • nutrition (Ca, vitamin D, energy)
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4
Q

What is the typical history associated with hip dysplasia?

A
  • exercise intolerance
  • buny-hop gait
  • difficulty rising/stiff after rest
  • reluctant to climb stairs or jump
  • sits to the side, avoiding hip flexion
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5
Q

What is seen on physical exam of a dog with hip dysplasia?

A
  • forward weight shift stance
  • hip sway gait
  • difficulty rising/sitting
  • muscle atrophy
  • pain on extension of hip
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6
Q

Describe the Ortolani test

A
  • requires sedation
  • dorsal or lateral recumbency
  • one hand on stifle, one dorsal to pelvis
  • push stifle proximally to subluxate
  • slowly abduct stifle
  • palpable/audible clunk indicates a positive test
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7
Q

What are the radiographic findings of a dog with hip dysplasia?

A
  • Morgan’s line: linear density between femoral head and greater trochanter
  • subluxation with < 50% acetabular coverage
  • coxa valga and thickening of femoral neck
  • flattening and sclerosis of femoral head
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8
Q

How is hip dysplasia treated medically?

A
  • lower Ca/vitamin D/energy diet in puppies
  • weight management
  • exercise modulation
  • physical therapy
  • NSAIDs
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9
Q

Which surgical procedures are used to manage hip dysplasia?

A
  • juvenile pubic symphiodesis
  • triple pelvic osteotomy
  • femoral head ostectomy
  • total hip replacement
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10
Q

Describe the JPS procedure

A
  • corrective procedure
  • fuse pubic symphysis
  • rolls acetabulum ventrally
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11
Q

Describe the TPO procedure

A
  • corrective procedure
  • improve femoral head coverage
  • rotate acetabulum dorsally
  • osteotomy of pubis, ischium, and ilium
  • fixation of ilium with angled plate
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12
Q

Describe the THR procedure

A
  • salvage procedure

- replace joint with prosthesis (femoral stem, acetabular cup)

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13
Q

Describe the FHO procedure

A
  • salvage procedure

- removal of entire femoral neck and head

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14
Q

What is the most common cause of coxofemoral luxation?

A

trauma

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15
Q

Describe a caudoventral coxofemoral luxation

A
  • excessive abduction of the limb
  • femoral head trapped ventral to ischium
  • leg held abducted and internally rotated
  • affected limb is longer
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16
Q

How is a caudoventral coxofemoral luxation treated?

A
  • closed reduction
  • open reduction if needed
  • general anesthesia needed
17
Q

What needs to be done post-reduction for a caudoventral luxation?

A
  • put joint through full ROM to clear debris
  • apply hobbles for 10-14 days
  • ehmer sling is contraindicated
18
Q

Describe a craniodorsal coxofemoral luxation

A
  • most common
  • greater trochanter displaced dorsally
  • affected leg held in relaxed extension
  • limb adducted and externally rotated
  • affected limb is shorter
19
Q

What needs to be done post-reduction for a craniodorsal luxation?

A
  • put joint through full ROM to clear debris
  • test stability
  • ehmer sling for 10-14 days
20
Q

What are the indications for an open reduction on a coxofemoral luxation?

A
  • pelvic/acetabular fracture
  • femoral fractures
  • unstable closed reduction
  • recurrent closed reduction
21
Q

What surgical treatments are used for coxofemoral luxations?

A
  • capsulorrhaphy
  • prosthetic capsule
  • toggle pin
  • salvage: FHO, THR
22
Q

What is the prognosis for coxofemoral luxations?

A
  • closed reduction more successful with recent injury

- open reduction good to excellent

small animal surgery (26 decks)

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