Hip (coxofemoral) joint conditions (Yr4) Flashcards
what are the ligaments that connect to the round head of the femur?
teres ligaments
what are the main muscles around the hip joint?
gluteals
what are the main developments conditions of the hip?
hip dysplasia
Legg-calve-perthes disease
what type of joint is the hip?
diarthrodial (wide range of motion)
how does the acetabulum of the dog and cat compare?
dogs is deep
cats is more shallow
what is the primary stabiliser of the hip joint?
teres ligament (ligament of the round head of the femur)
what helps to stabilise the hip joint?
teres ligament
joint capsule
gluteal muscles
what does the sciatic nerve divide into?
tibial and perineal nerve
where does the sciatic nerve divide into the tibial and perineal nerves?
level with the stifle
what are the landmarks of the hip joint?
wing of ileum
ischiatic tuberosity
greater trochanter
(form a triangle)
what should be done on a clinical exam of the hip joint?
flexion and extension
internal/external rotation in extension
abduction and adduction
(try do without stifle flexing)
what are some predisposing factors of hip dysplasia?
genetics
bodyweight
nutrition (high protein)
growth rate (fast)
what is the pathogenesis of hip dysplasia?
laxity due to poor tissue coverage then osteoarthritic changes due to this
what does hip dysplasia lead to?
oesteoarthritis
what causes the pain associated with hip dysplasia?
femoral head hitting dorsal acetabular rim
what age dogs usually present with hip dysplasia?
8-12 months old
what breeds are predisposed to hip dysplasia?
labradors
rottweilers
collies
setters
what are the clinical signs immature dogs with hip dysplasia present with?
unilateral/bilateral hindlimb lameness
bunny hopping (back legs move together)
reluctance to exercise
pain upon flexion/extension
positive ortolani test
what are the two groups of dogs that present with hip dysplasia?
young immature (<12 months)
older dogs with osteoarthritis
what clinical signs do mature dogs with hip dysplasia present with?
stiffness after rest/exercise
bunny hopping
bilateral lameness
pain upon manipulation
reduced range of motion
what static radiographic views should be taken for suspected hip dysplasia?
ventrodorsal extended/frog-legged
lateromedial view
what are some early (primary) radiographic changes associated with hip dysplasia?
wide joint space with medial divergence
less than 50% of femoral head within the acetabulum
what are some secondary radiographic changes associated with hip dysplasia?
new bone formation of femoral neck
remodelling of femoral head/neck
remodelling of acetabular rim
what are the two options for treating mip dysplasia?
conservative
surgical
when should conservative management of hip dysplasia be used?
always worth trying unless dog is very painful or if owners very keen for surgery
how can hip dysplasia be conservatively/medically managed?
analgesia (NSAIDs and paracetamol)
weight control
exercise/environmental modification
nutritional management (nutraceuticals)
educate owners
what surgical interventions are available for young dogs with hip dysplasia?
double/triple pelvic osteotomy
juvenile pubic symphisiodesis
what surgical interventions are available for all dogs with hip dysplasia?
femoral head and neck excision
total hip replacement (>9 months)
why should you exercise dogs after femoral head and neck excisions?
gluteal muscles give the main portion of the stability for the joint, hence they need to be strengthened
what is the gold standard treatment of hip dysplasia?
total hip replacement
when does JPS treatment of hip dysplasia have to be done?
before 20 weeks of age
what is JPS treatment of hip dysplasia?
intermittent electrocautery of the pubic chondrocytes to shorten the pubic bones and cause ventrolateral rotation of the acetabulum
what breeds is Legg-calve-perthes disease seen in?
small breeds (terriers, westies…)
what is Legg-calve-perthes disease?
an ischaemia of the femoral head leading to deformities and collapse
how should Legg-calve-perthes disease be treated?
surgery (femoral head and neck excision of total hip replacement)
what disease is similar to Legg-calve-perthes disease, but seen in cats?
slipped femoral capital physis
what age animals are capital physical fractures seen in?
immature (4-7 months old) secondary to trauma
what is the first thing to do when presented with a pelvic fracture?
stables the animal
what is a very poor prognostic indicator for pelvic fractures?
no movement or deep pain
what should be assessed if you find one fracture of the pelvis?
look for the second one (will always be two as the pelvis is shaped like a box)
what pelvic fractures are suitable for conservative management?
if they are non-weight bearing (pubis, ischium, wing of ilium)
what conservative management should be given to pelvic fracture cases?
cage/small room rest for 4-6 weeks
turning then and padded bedding (if non-ambulatory)
check bladder qid if not urinating
analgesia (opioids)
what is the analgesia of choice for pelvic fractures?
opioids (full or partial agonists) - buprenorphine
what pelvic fractures need surgery?
weight bearing - acetabulum, ipsilateral fractures of ilium/pubis/ischium, iliac shaft, sacroiliac joint
severely painful
neurological deficits
what is the post-operative care for pelvic fractures?
cage/small room rest for 4-6 weeks
short lead walks (10 minutes)
see at 3 and 7 days, and 4-8 weeks
analgesia and soft bedding
physiotherapy/hydrotherapy
