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Orthopaedics (SA) > Hip > Flashcards

Hip Flashcards

1
Q

The hip is a diarthrodial joint. What does this mean?

A

Articulating bones separated by a fluid-containing joint cavity
(Most common joint)

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2
Q

What are 2 developmental conditions of the hip?

A

Hip dysplasia

Legg-Calve-Perthe’s disease

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3
Q

What are some acquired conditions of the hip joint?

A

Osteoarthritis
Neoplasia
Immune mediated arthropathy

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4
Q

What are some traumatic conditions of the hip?

A

Coxofemoral luxation
Fractures of femoral head and neck
Fractures of acetabulum

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5
Q

What causes hip dysplasia?

A

Laxity and instability of hip joint
Causes osteoarthritis
Results in pain as femoral head hits acetabular rim

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6
Q

What are the risk factors for hip dysplasia?

A 
Large breed dogs
Devon Rex Cat
Genotype
Bodyweight
Nutrition 
Growth rate
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7
Q

What breed cat is predisposed to hip dysplasia?

A

Devon Rex

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8
Q

At what age do the clinical signs of hip dysplasia subside?

A

12-18 months

Dogs present young (<12 months)

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9
Q

What two ages of dogs usually present with hip dysplasia?

A

Young dogs - <12 months

Adult dogs with osteoarthritis secondary to HD

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10
Q

What are the clinical signs of young dogs (<1) with hip dysplasia?

A 
Unilateral/bilateral HL lameness
Bunny hopping
Reluctance to exercise
Pain upon hip/extension flexion 
Positive Ortalani test
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11
Q

What is the Ortolani test?

A

Used to diagnose hip dysplasia

Under sedation, hip manipulation will cause subluxation and popping

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12
Q

What are the clinical signs of hip dysplasia in adult dogs?

A 
Stiffness after rest/exercise
Bunny hopping
Usually bilateral lameness
Pain upon joint manipulation 
Reduced ROM
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13
Q

How is hip dysplasia diagnosed?

A

History
Clinical signs
Radiography

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14
Q

What EARLY radiologic changes are seen with hip dysplasia?

A

Wide joint space with medial divergence

centre of femoral head lateral to dorsal acetabular edge

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15
Q

What secondary radiologic changes are seen with hip dysplasia?

A

New bone formation of femoral neck (Morgan line)

Remodelling of femoral head/neck and cranial acetabular rim

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16
Q

What are the treatment options for hip dysplasia?

A

Conservative - exercise restriction, NSAIDs

Surgery (if non-responsive to conservative management)

17
Q

What surgery can be performed to treat hip dysplasia?

A

Total hip replacement (all ages- Tx of choice)
Femoral head and neck excision (all ages)
(Triple pelvic osteotomy, juvenile pubic symphisiodesis - young dogs only)

18
Q

What are the indications for femoral head and neck excision surgery?

A

Legg-Calve-Perthe’s disease
Unreducible fractures
Hip dysplasia

19
Q

What are contraindications for a total hip replacement?

A

Chronic systemic illnesses

E.g. skin problems

20
Q

What are the disadvantages of a total hip replacement?

A

Expensive!

Cannot be done if chronic systemic illness (e.g. skin problems)

21
Q

What breeds are prone to Legg-Calve-Perthe’s disease?

A

Small breeds

WHWT, Manchester terriers

22
Q

What is the pathogenesis of Legg-Calve-Perthe’s disease?

A

Ischaemia of femoral head bone

Leads to deformity and collapse

23
Q

What age dogs are usually seen with Legg-Calve-Perthe’s disease?

A

Young (5 months old)

24
Q

What are the clinical signs of Legg-Calve-Perthe’s disease?

A 
Unilateral lameness (usually) 
Young dog (5 months)
Pain and crepitus upon hip manipulation
25
Q

How is Legg-Calve-Perthe’s disease diagnosed?

A

Radiography (frog leg and VD extended)

26
Q

What is the treatment for Legg-Calve-Perthe’s disease?

A

Surgery > conservative
Femoral head and neck excision (Tx of choice)
Total hip replacement
(Post-op rehab very important)

27
Q

What fractures can be seen in the proximal femur?

A

Capital and capital physical fractures
Femoral neck fractures
Greater trochanter fractures

28
Q

In what age animals are capital physeal fractures usually seen?

A

Young - 4-7 m/o

29
Q

What are the clinical signs of capital physeal fractures?

A

Young animal (4-7 months)
Pain upon hip maniuplation
History - secondary to trauma

30
Q

What is the treatment for capital physeal fractures?

A

Surgery

3 divering/parallel K or arthrodesis wires

31
Q

What is the most common luxation in small animals?

A

Coxofemoral (hip)

32
Q

What animals are usually affected by coxofemoral lunation?

A

Animals >12 months

Following major trauma e.g. RTA

33
Q

Coxofemoral lunation can occur in any direction, but which is most common?

A

Craniodorsal

34
Q

What are the clinical signs of coxofemoral lunation?

A

Leg carried in flexion - stifle out, hock in

Greater trochanter more prominent - look for asymmetry

35
Q

How is coxofemoral lunation diagnosed?

A

History and clinical signs

Radiography (2 views - rule out other problems such as capital fractures and hip dysplasia)

36
Q

What is the treatment for coxofemoral lunation?

A 
Closed reduction (manipulation of the joint without incising) unless hip dysplasia, or avulsion fracture
If re-luxation occurs then open reduction and stabilisation
37
Q

Within what timeframe of a coxofemoral lunation should a closed reduction be performed? How is this done?

A

Within 48 hrs (if over this time = surgery)
Under GA - tie dog to table
(Radiograph after to ensure reduction)

38
Q

What may cause reluxation of the coxofemoral joint after closed reduction?

A

Haematoma

Fragments in acetabulum

Orthopaedics (SA) (10 decks)

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