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Surgery (small) > Hip (coxofemoral) joint conditions (Yr4) > Flashcards

Hip (coxofemoral) joint conditions (Yr4) Flashcards

1
Q

what are the ligaments that connect to the round head of the femur?

A

teres ligaments

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2
Q

what are the main muscles around the hip joint?

A

gluteals

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3
Q

what are the main developments conditions of the hip?

A

hip dysplasia
Legg-calve-perthes disease

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4
Q

what type of joint is the hip?

A

diarthrodial (wide range of motion)

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5
Q

how does the acetabulum of the dog and cat compare?

A

dogs is deep
cats is more shallow

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6
Q

what is the primary stabiliser of the hip joint?

A

teres ligament (ligament of the round head of the femur)

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7
Q

what helps to stabilise the hip joint?

A

teres ligament
joint capsule
gluteal muscles

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8
Q

what does the sciatic nerve divide into?

A

tibial and perineal nerve

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9
Q

where does the sciatic nerve divide into the tibial and perineal nerves?

A

level with the stifle

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10
Q

what are the landmarks of the hip joint?

A

wing of ileum
ischiatic tuberosity
greater trochanter
(form a triangle)

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11
Q

what should be done on a clinical exam of the hip joint?

A

flexion and extension
internal/external rotation in extension
abduction and adduction
(try do without stifle flexing)

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12
Q

what are some predisposing factors of hip dysplasia?

A

genetics
bodyweight
nutrition (high protein)
growth rate (fast)

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13
Q

what is the pathogenesis of hip dysplasia?

A

laxity due to poor tissue coverage then osteoarthritic changes due to this

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14
Q

what does hip dysplasia lead to?

A

oesteoarthritis

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15
Q

what causes the pain associated with hip dysplasia?

A

femoral head hitting dorsal acetabular rim

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16
Q

what age dogs usually present with hip dysplasia?

A

8-12 months old

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17
Q

what breeds are predisposed to hip dysplasia?

A

labradors
rottweilers
collies
setters

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18
Q

what are the clinical signs immature dogs with hip dysplasia present with?

A

unilateral/bilateral hindlimb lameness
bunny hopping (back legs move together)
reluctance to exercise
pain upon flexion/extension
positive ortolani test

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19
Q

what are the two groups of dogs that present with hip dysplasia?

A

young immature (<12 months)
older dogs with osteoarthritis

20
Q

what clinical signs do mature dogs with hip dysplasia present with?

A

stiffness after rest/exercise
bunny hopping
bilateral lameness
pain upon manipulation
reduced range of motion

21
Q

what static radiographic views should be taken for suspected hip dysplasia?

A

ventrodorsal extended/frog-legged
lateromedial view

22
Q

what are some early (primary) radiographic changes associated with hip dysplasia?

A

wide joint space with medial divergence
less than 50% of femoral head within the acetabulum

23
Q

what are some secondary radiographic changes associated with hip dysplasia?

A

new bone formation of femoral neck
remodelling of femoral head/neck
remodelling of acetabular rim

24
Q

what are the two options for treating mip dysplasia?

A

conservative
surgical

25
Q

when should conservative management of hip dysplasia be used?

A

always worth trying unless dog is very painful or if owners very keen for surgery

26
Q

how can hip dysplasia be conservatively/medically managed?

A

analgesia (NSAIDs and paracetamol)
weight control
exercise/environmental modification
nutritional management (nutraceuticals)
educate owners

27
Q

what surgical interventions are available for young dogs with hip dysplasia?

A

double/triple pelvic osteotomy
juvenile pubic symphisiodesis

28
Q

what surgical interventions are available for all dogs with hip dysplasia?

A

femoral head and neck excision
total hip replacement (>9 months)

29
Q

why should you exercise dogs after femoral head and neck excisions?

A

gluteal muscles give the main portion of the stability for the joint, hence they need to be strengthened

30
Q

what is the gold standard treatment of hip dysplasia?

A

total hip replacement

31
Q

when does JPS treatment of hip dysplasia have to be done?

A

before 20 weeks of age

32
Q

what is JPS treatment of hip dysplasia?

A

intermittent electrocautery of the pubic chondrocytes to shorten the pubic bones and cause ventrolateral rotation of the acetabulum

33
Q

what breeds is Legg-calve-perthes disease seen in?

A

small breeds (terriers, westies…)

34
Q

what is Legg-calve-perthes disease?

A

an ischaemia of the femoral head leading to deformities and collapse

35
Q

how should Legg-calve-perthes disease be treated?

A

surgery (femoral head and neck excision of total hip replacement)

36
Q

what disease is similar to Legg-calve-perthes disease, but seen in cats?

A

slipped femoral capital physis

37
Q

what age animals are capital physical fractures seen in?

A

immature (4-7 months old) secondary to trauma

38
Q

what is the first thing to do when presented with a pelvic fracture?

A

stables the animal

39
Q

what is a very poor prognostic indicator for pelvic fractures?

A

no movement or deep pain

40
Q

what should be assessed if you find one fracture of the pelvis?

A

look for the second one (will always be two as the pelvis is shaped like a box)

41
Q

what pelvic fractures are suitable for conservative management?

A

if they are non-weight bearing (pubis, ischium, wing of ilium)

42
Q

what conservative management should be given to pelvic fracture cases?

A

cage/small room rest for 4-6 weeks
turning then and padded bedding (if non-ambulatory)
check bladder qid if not urinating
analgesia (opioids)

43
Q

what is the analgesia of choice for pelvic fractures?

A

opioids (full or partial agonists) - buprenorphine

44
Q

what pelvic fractures need surgery?

A

weight bearing - acetabulum, ipsilateral fractures of ilium/pubis/ischium, iliac shaft, sacroiliac joint
severely painful
neurological deficits

45
Q

what is the post-operative care for pelvic fractures?

A

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

46
Q
A

Surgery (small) (14 decks)

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