Hip Flashcards
What is hip dysplasia?
abnormal development of the coxofemoral joint
Describe the pathogenesis of hip dysplasia
- 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
What factors contribute to expression of hip dysplasia?
- genetics
- pelvic muscle mass
- body weight
- nutrition (Ca, vitamin D, energy)
What is the typical history associated with hip dysplasia?
- exercise intolerance
- buny-hop gait
- difficulty rising/stiff after rest
- reluctant to climb stairs or jump
- sits to the side, avoiding hip flexion
What is seen on physical exam of a dog with hip dysplasia?
- forward weight shift stance
- hip sway gait
- difficulty rising/sitting
- muscle atrophy
- pain on extension of hip
Describe the Ortolani test
- 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
What are the radiographic findings of a dog with hip dysplasia?
- 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
How is hip dysplasia treated medically?
- lower Ca/vitamin D/energy diet in puppies
- weight management
- exercise modulation
- physical therapy
- NSAIDs
Which surgical procedures are used to manage hip dysplasia?
- juvenile pubic symphiodesis
- triple pelvic osteotomy
- femoral head ostectomy
- total hip replacement
Describe the JPS procedure
- corrective procedure
- fuse pubic symphysis
- rolls acetabulum ventrally
Describe the TPO procedure
- corrective procedure
- improve femoral head coverage
- rotate acetabulum dorsally
- osteotomy of pubis, ischium, and ilium
- fixation of ilium with angled plate
Describe the THR procedure
- salvage procedure
- replace joint with prosthesis (femoral stem, acetabular cup)
Describe the FHO procedure
- salvage procedure
- removal of entire femoral neck and head
What is the most common cause of coxofemoral luxation?
trauma
Describe a caudoventral coxofemoral luxation
- excessive abduction of the limb
- femoral head trapped ventral to ischium
- leg held abducted and internally rotated
- affected limb is longer