Hip dysplasia Flashcards
What are the multifactorial underlying processes that result in hip dysplasia?
!!!!Hip laxity!!!!
- Genetics, nutrition, skeletal development, environmental factors “epigenetics”
- Hip dysplasia and subsequent osteoarthritis are the clinical manifestations of the above
- Hip laxity–> poor joint congruence/subluxation abnormal hip development
What is the normal coverage of the femoral head by the acetabulum?
50-60% coverage
CCO- caudal lateral curvilinear osteophyte aka Morgan’s line, what is it?
Term used frequently to describe where the joint capsule attaches from pelvic side to femur circumferentially.
Morgan line seen with some mineralization (white line) on rad, what does this indicate?
indicates joint laxity around femoral neck– predisposed to OA
Have to be at least ____ years old to get OFA
2 yrs old
PennHip:
stress rads to detect joint laxity, must be certified as a Dr to do this, more objective and accurate. Can be PREDICTIVE of the development of OA as early as 16 weeks old!!! only a measure of hip, not a certification process
Penn hip can be predictive and used in pups as young as 16 weeks. T/F
True!!!!
Penn hip:
DI of 0 means ?
DI of 1 means?
DI 0= no laxity
DI 1= severe laxity/luxated
What is the most impt factor in development of arthritis?
Laxity!!!!!
Passive laxity is best measured by what test?
PennHip
what is “functional laxity”??
pathological form of laxity that occurs during weight bearing
Places abnormal forces on the joint surfaces leading to joint damage…. there is NOOOO current test for functional laxity
What does Distraction Index mean?
Probability that the animal will develop OA as the animal ages, can be somewhat breed specific but generally a DI of more than 0.3 is considered susceptible for OA development
Is none weight bearing lameness common in hip dysplasia p?
NOOOOO
What are the plans of tx of hip dysplasia for immature dogs that are still growing?
Medical tx, TPO, JPS
What are the plans for tx for mature dogs with OA?
Medical tx, THA, FHO
What is the procedure that is done the most, and can be a preventative measure to decrease the development of arthritis but cannot prevent OA if already begun?
TPO- Triple pelvic osteotomy
TPO characteristics-
ii. Ileum, ischium, and pubis are cut and pelvis is rotated so the femoral head is covered more
iii. Done in dogs 8-12 months of age
iv. Derived from studies done on kids, reorientation of the acetabulum
Prognosis after TPO sx-
improved lameness in 92% of individuals and progression of OA is successfully delayed
Fusion of the pubic symphysis by destruction of growth plate using electrocautery=
Juvenile Pubic Symphysiotomies (JPS)
When is the best time to do sx for juv. pelvic symphysis?
less than 16 weeks (or 20 weeks in giant breeds), no benefits in animals more than 24 weeks of age
What is the goal for the JPS sx?
destroy the growth plate of the ischium allows other sides of pelvis to grow but not the ischium
Not super invasive, neuter-like incision done
Less side effects than TPO, less equipment needed
If JPS sx is so easy, without a lot of equipment needed, then why do we not do it more often?
usually the CHD is not found this early on in the puppy’s life
FHO is usually done in _____ dogs, and relies of the formation of ______ which acts like a fake joint taking up space and is made up of scar tissues
smaller dogs; pseudoarthritis
Total hip arthroplasty (THA) aka total hip replacement surgery is usually for ____ breeds, but can be performed on others too. When should we NOT do this surgery?
Larger breed dogs; Do not do this surgery if:
- If patient has infection or cancer (infection because if the infection occurs, we have to remove alllll of the hardware and cannot do it all over again)
- Cruciate disease
- Neuro issues
With THA, there is a ___% success rate, owner compliance is SUPERRR impt. If patient has bilateral hip issues, usually only doing one leg will provide them with enough relief
95%
What is the medical/conservative management for CHD (canine hips dysplasia)?
OA disease modification meds, NSAIDS, Tylenol 4, PT, weight management, polyunsaturated FA
What is Ortolani sign?
Ortolani’s sign is the palpable sensation of the femoral head slipping into the acetabulum. Ortolani described the accompanying sound as a click; it is more often thought of as a clunk nowadays, although audibility is by no means an essential requirement.
