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Small Animal Surgery > Hip Dysplasia > Flashcards

Hip Dysplasia Flashcards

1
Q

Canine hip dysplasia is a ____ disease in dogs.

A

Developemental

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2
Q

Canine hip dysplasia is characterized by hip ____.

A

Laxity

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3
Q

Osteoarthritis is ____ to canine hip dysplasia.

A

Secondary

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4
Q

True or False: Canine hip dysplasia is a multifactoral disease.

A

TRUE

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5
Q

What are the 3 factors involved in the development of CHD?

A
  1. Environmental factors
  2. Rapid growth
  3. Heredity factors
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6
Q

___ % of bulldogs are dysplastic.

A

70%

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7
Q

What are the 5 factors/structures involved in the stability of the hip joint?

A
  1. Ligament of the head of the femur
  2. Joint fluid
  3. Joint capsule
  4. Muscles
  5. Conformation
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8
Q

True or False: Eventual thickening may result in stabilization and secession of clinical signs at skeletal maturity.

A

TRUE

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9
Q

What are the 3 stabilizing muscles of the hip joint?

A
  1. Iliopsoas
  2. Pectineus
  3. Adductor
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10
Q

These muscles are ____ stabilizers of the hip joint.

A

Secondary

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11
Q

Rapid growth in young dogs may cause disparity between ___ and ___ size.

A

Rapid growth in young dogs may cause disparity between MUSCLE and BONE size.

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12
Q

What are the two common signalments associated with CHD?

A
  1. Young, rapidly growing large-breed dog

2. Middle-aged to older large-breed dog

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13
Q

The young, rapidly growing large-breed dogs are painful from ____.

A

Laxity

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14
Q

The middle-age to older large-breed dogs are painful from ___ ___.

A

Secondary osteoarthritis

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15
Q

What are 6 clinical signs associated with CHD?

A
  1. Decreased activity
  2. Difficulty rising
  3. Reluctance to run or climb stairs
  4. Bunny-hopping
  5. Narrowed stance
  6. Hyperextended hocks
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16
Q

What might you find on physical exam for CHD? (5 findings listed)

A
  1. Muscle atrophy (typically symmetric)
  2. Hip pain on extension
  3. Decreased hip ROM
  4. Palpable crepitus
  5. Symmetric hind-limb lameness (marilyn monroe walk)
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17
Q

True or False: The Ortolani sign is never normal.

A

TRUE

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18
Q

True or False: The Ortolani sign can be done without sedation.

A

FALSE - sedation should be provided

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19
Q

The Ortolani sign is a maneuver to elicit hip ____ and ____.

A

Subluxation and reduction

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20
Q

Describe the ortolani technique, step by step.

A
  1. Adduct the stifle
  2. Push femur dorsally
  3. Apply light pressure on the greater trochanter
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21
Q

What is the sign of a positive ortolani sign?

A

An audible or physical “pop”

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22
Q

In which 2 positions can the ortolani sign be performed? Which is preferred?

A
  1. Lateral recumbency (preferred)

2. Dorsal recumbency

23
Q

If any animal does have CHD, but you are unable to get a positive ortolani sign, what are the 3 possible reasons for that?

A
  1. Poor technique
  2. Muscle tension
  3. Advanced osteoarthritis
24
Q

Explain the radiographic positioning of an animal so critical to diagnosing CHD.

A
  1. Straight pelvis
  2. Extended femurs
  3. Straight femurs (rotated inward so patella lies in the trochlear groove)
25
Q

True or False: The dog must be anesthetized for radiography of CHD.

A

TRUE - this is necessary for proper relaxation

26
Q

What are the 4 radiographic signs of CHD?

A

1.

27
Q

True or False: Dogs must be >2.5 years of age for official Orthopedic Foundation of Animals hip radiographs.

A

FALSE: must be >2 years old

28
Q

What are the 3 views for the PennHIP radiographs?

A
  1. Distracted view (laxity)
  2. Compression view
  3. Hip extended view
29
Q

At what age can PennHIP radiographs be performed?

A

As early as 16 weeks of age

30
Q

What is the distraction index and what is its range?

A

The measure of hip laxity, or the distance the head can be displaced from the acetabulum (0-1)

31
Q

True or False: A distraction index near 0 indicates little joint laxity.

A

TRUE

32
Q

If the distraction index is less than ___, then hip dysplasia is unlikely to occur.

A

0.3

33
Q

What are your medical management options for hip dysplasia?

A
  1. Weight management
  2. Chrondroprotectives
  3. Exercise moderation
  4. NSAIDs
34
Q

What are the 4 surgical options for management of hip dysplasia?

A
  1. Juvenile pubic symphysiodesis (JPS)
  2. Triple pelvic osteotomy (TPO)
  3. Femoral head and neck excision (FHO)
  4. Total hip replacement
35
Q

What is the best option for the following dysplastic patient: skeletally immature, less than 16 weeks old?

A

JPS (Juvenile pubic symphysiodesis)

36
Q

Which procedure is the following describing: electrocautery applied to the ventral portion of the pubic symphysis?

A

JPS (Juvenile pubis symphysiodesis)

37
Q

JPS stops growth ventrally or dorsally?

A

Ventrally (growth dorsally continues)

38
Q

JPS is best when performed before a patient is ___ - ___ weeks of age.

A

12 - 16

39
Q

What is the best treatment option for the following dysplastic patient: skeletally immature, less than 11 months old, with minimal to no OA?

A

TPO

40
Q

Which procedure involves an osteotomy of the pubis, ischium, and ilium?

A

TPO

41
Q

The TPO involves ventral or dorsal rotation of the acetabular segment?

A

Ventral

42
Q

What is the result of the TPO procedure?

A

Increased dorsal coverage of the femoral head

43
Q

What are the best candidates for a TPO?

A
  1. 5-10 months of age
  2. Minimal to no radiographic evidence of OA
  3. Good femoral head capture (crisp Ortolani “pop”)
44
Q

True or False: TPO can stop the progression of OA.

A

FALSE: TPO does NOT stop OA.

45
Q

What are the 4 complications of a TPO?

A
  1. Implant loosening
  2. Narrowed pelvic canal
  3. Urethral obstruction
  4. Femoral neck impingement
46
Q

What is the best treatment option for the following dysplastic patient: skeletally immature, less than 11 months, with presence of OA or severe laxity?

A

Medical management, at least until skeletally mature, then consider surgery (THR, FHO)

47
Q

True or False: There will always be a gait abnormality after an FHO.

A

TRUE

48
Q

Which of the following procedures are salvage procedures: FHO, TPO, THR?

A

FHO & TRH

49
Q

True or False: A total hip repalcement would allow FULL range of motion.

A

TRUE

50
Q

For which size dogs or cats would you reserve the FHO and THR procedures?

A

ANY size

51
Q

The success rate of total hip replacements is greater than ___%.

A

90%

52
Q

___% of dogs only need unilateral THR.

A

80%

53
Q

What are the 5 criteria for an ideal THR candidate?

A
  1. Their sole problem is hip dysplasia/OA
  2. No neurologic disease
  3. No neoplasia
  4. No CCL rupture
  5. No infections
54
Q

True or False: THR complications are rather common and serious.

A

FALSE: THR complications are uncommon, but are serious!

Small Animal Surgery (11 decks)

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