Hip Dysplasia Flashcards
Canine hip dysplasia is a ____ disease in dogs.
Developemental
Canine hip dysplasia is characterized by hip ____.
Laxity
Osteoarthritis is ____ to canine hip dysplasia.
Secondary
True or False: Canine hip dysplasia is a multifactoral disease.
TRUE
What are the 3 factors involved in the development of CHD?
- Environmental factors
- Rapid growth
- Heredity factors
___ % of bulldogs are dysplastic.
70%
What are the 5 factors/structures involved in the stability of the hip joint?
- Ligament of the head of the femur
- Joint fluid
- Joint capsule
- Muscles
- Conformation
True or False: Eventual thickening may result in stabilization and secession of clinical signs at skeletal maturity.
TRUE
What are the 3 stabilizing muscles of the hip joint?
- Iliopsoas
- Pectineus
- Adductor
These muscles are ____ stabilizers of the hip joint.
Secondary
Rapid growth in young dogs may cause disparity between ___ and ___ size.
Rapid growth in young dogs may cause disparity between MUSCLE and BONE size.
What are the two common signalments associated with CHD?
- Young, rapidly growing large-breed dog
2. Middle-aged to older large-breed dog
The young, rapidly growing large-breed dogs are painful from ____.
Laxity
The middle-age to older large-breed dogs are painful from ___ ___.
Secondary osteoarthritis
What are 6 clinical signs associated with CHD?
- Decreased activity
- Difficulty rising
- Reluctance to run or climb stairs
- Bunny-hopping
- Narrowed stance
- Hyperextended hocks
What might you find on physical exam for CHD? (5 findings listed)
- Muscle atrophy (typically symmetric)
- Hip pain on extension
- Decreased hip ROM
- Palpable crepitus
- Symmetric hind-limb lameness (marilyn monroe walk)
True or False: The Ortolani sign is never normal.
TRUE
True or False: The Ortolani sign can be done without sedation.
FALSE - sedation should be provided
The Ortolani sign is a maneuver to elicit hip ____ and ____.
Subluxation and reduction
Describe the ortolani technique, step by step.
- Adduct the stifle
- Push femur dorsally
- Apply light pressure on the greater trochanter
What is the sign of a positive ortolani sign?
An audible or physical “pop”
In which 2 positions can the ortolani sign be performed? Which is preferred?
- Lateral recumbency (preferred)
2. Dorsal recumbency
If any animal does have CHD, but you are unable to get a positive ortolani sign, what are the 3 possible reasons for that?
- Poor technique
- Muscle tension
- Advanced osteoarthritis
Explain the radiographic positioning of an animal so critical to diagnosing CHD.
- Straight pelvis
- Extended femurs
- Straight femurs (rotated inward so patella lies in the trochlear groove)
True or False: The dog must be anesthetized for radiography of CHD.
TRUE - this is necessary for proper relaxation
What are the 4 radiographic signs of CHD?
1.
True or False: Dogs must be >2.5 years of age for official Orthopedic Foundation of Animals hip radiographs.
FALSE: must be >2 years old
What are the 3 views for the PennHIP radiographs?
- Distracted view (laxity)
- Compression view
- Hip extended view
At what age can PennHIP radiographs be performed?
As early as 16 weeks of age
What is the distraction index and what is its range?
The measure of hip laxity, or the distance the head can be displaced from the acetabulum (0-1)
True or False: A distraction index near 0 indicates little joint laxity.
TRUE
If the distraction index is less than ___, then hip dysplasia is unlikely to occur.
0.3
What are your medical management options for hip dysplasia?
- Weight management
- Chrondroprotectives
- Exercise moderation
- NSAIDs
What are the 4 surgical options for management of hip dysplasia?
- Juvenile pubic symphysiodesis (JPS)
- Triple pelvic osteotomy (TPO)
- Femoral head and neck excision (FHO)
- Total hip replacement
What is the best option for the following dysplastic patient: skeletally immature, less than 16 weeks old?
JPS (Juvenile pubic symphysiodesis)
Which procedure is the following describing: electrocautery applied to the ventral portion of the pubic symphysis?
JPS (Juvenile pubis symphysiodesis)
JPS stops growth ventrally or dorsally?
Ventrally (growth dorsally continues)
JPS is best when performed before a patient is ___ - ___ weeks of age.
12 - 16
What is the best treatment option for the following dysplastic patient: skeletally immature, less than 11 months old, with minimal to no OA?
TPO
Which procedure involves an osteotomy of the pubis, ischium, and ilium?
TPO
The TPO involves ventral or dorsal rotation of the acetabular segment?
Ventral
What is the result of the TPO procedure?
Increased dorsal coverage of the femoral head
What are the best candidates for a TPO?
- 5-10 months of age
- Minimal to no radiographic evidence of OA
- Good femoral head capture (crisp Ortolani “pop”)
True or False: TPO can stop the progression of OA.
FALSE: TPO does NOT stop OA.
What are the 4 complications of a TPO?
- Implant loosening
- Narrowed pelvic canal
- Urethral obstruction
- Femoral neck impingement
What is the best treatment option for the following dysplastic patient: skeletally immature, less than 11 months, with presence of OA or severe laxity?
Medical management, at least until skeletally mature, then consider surgery (THR, FHO)
True or False: There will always be a gait abnormality after an FHO.
TRUE
Which of the following procedures are salvage procedures: FHO, TPO, THR?
FHO & TRH
True or False: A total hip repalcement would allow FULL range of motion.
TRUE
For which size dogs or cats would you reserve the FHO and THR procedures?
ANY size
The success rate of total hip replacements is greater than ___%.
90%
___% of dogs only need unilateral THR.
80%
What are the 5 criteria for an ideal THR candidate?
- Their sole problem is hip dysplasia/OA
- No neurologic disease
- No neoplasia
- No CCL rupture
- No infections
True or False: THR complications are rather common and serious.
FALSE: THR complications are uncommon, but are serious!
