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ACVN - SURGICAL NURSING > Hip Dysplasia - advanced nursing > Flashcards

Hip Dysplasia - advanced nursing Flashcards

1
Q

What is hip dysplasia?

A

a common inherited, developmental disease of the hip joint

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2
Q

How is hip dysplasia characterised?

A

hip laxity or instabilty and development of osetoarthritis

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3
Q

What breeds are clinical signs more apparent in?

A

large breeds such as labradors, german shpeherds and golden retrievers

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4
Q

When does laxity become apparent?

A

4-5 months old

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5
Q

What does laxity allow the hip to do?

A

subluxate

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6
Q

What is axity influenced by?

A

size of dog, rate of growth, diet, and exercise

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7
Q

What does laxity of the hip result in?

A

inflammation and pain

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8
Q

What does inflammation of the joint lead to?

A

increase in joint fluid and thickening of the joint capsule

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9
Q

What ligament can become stretched or ruptured allowing subluxation or laxity?

A

round or teres ligament

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10
Q

What happens to the femoral headdue to laxity?

A

it becomes flattened with new bone produced at the margins of the head and around the femoral neck

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11
Q

What are common presenting complaints with a hip dysplasia?

A

bunny hopping, difficulty rising, pelvic limb lameness or stiffness, exercise interolerance, clicking or clunking of the hips

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12
Q

What is crepitus?

A

hip grinding as hip taken through range of motion, felt with hand over hip joint

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12
Q

What might you see on orthopaedic examination?

A

muscle atrophy, pain on hip extension and abduction, crepitus, clunking, lateral sway, instability

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13
Q

Why might a hip ‘clunk’?

A

it is the hip popping back into place

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14
Q

What is a lateral sway?

A

When the dog tries to protect the hips and uses the spine to propel the pelvic limbs forward

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15
Q

What radiography views would you do to diagnose hip dysplasia?

A

orthogonol, ventrodorsal extended leg and frog leg

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16
Q

How is hipdysplasia diagnosed using radiographs?

A

identifying hip subluxation and secondary osteoarthritis

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17
Q

What severity of hip dysplasia can ultrasound diagnose?

A

early detection of dogs with mild to moderate dysplasia

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18
Q

What is an example of palpation tests for diagnosis?

A

ortolani test

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19
Q

What does the ortolani test mimic?

A

weight bearing

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20
Q

What is the angle of reduction?

A

when the femur is taken away from midline and pops back in, the angle this occurs at is the angle of reduction

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21
Q

What is the angle of subluxation?

A

when you bring the femur backto midline and the hip subluxates, the anglethis occurs at is the angle of subluxation

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22
Q

What does a positive ortolani test suggest?

A

hip laxity

23
Q

What does a negative ortolani test suggets?

A

complete dislocation

24
Q

What is the bardens hip lift test?

A

when you try to lever the hip out of the acetabulum and see how much bounce there is

25
Q

What is abnormal with a bardens hip lift test?

A

more than half a cm of bounce

26
Q

What are the treatment options for hip dysplasia?

A
  • non-surgical
  • myotomies
  • growth plate fusion
  • osteotomies
  • total hip replacement
  • femoral head and neck excision
27
Q

When is surgical treatment considered?

A
  • significant clinical signs
  • failure to respond to conservative management
28
Q

What is involved in conservative treatment?

A
  • restricting exercise to leash only
  • introducing hydrotherapy
  • controlling food intake to restrict weight gain and slow down growth
  • NSAIDs and other meds
28
Q

What is the first line of treatment?

A

conservative treatment

29
Q

What dogs might be considered for conservative management?

A

younger dogs

30
Q

What lifestyle adjustments can be made?

A

weightloss, exercise, hydrotherapy

31
Q

What surgical management options are there?

A
  • growth plate fusion
  • osteotomies
  • total joint replacements
  • ostectomies`
32
Q

What is juvenile pubic symphysiodesis?

A

improves coxal joint congruecy in clinically affected immature dogs before secondary arthritic changes develop

33
Q

What does symphysiodesis imply?

A

fusion of a symphysis, which is achieved by the use off electrocautery

34
Q

What types of dogs is juvenile pubic symphysiodesis performed in?

A

skeletally immature dogs

35
Q

What does triple or double pelvic osteotomy iincrease?

A

dorsal coverage of the femoral head,corrects subluxation and restores the hips weight bearing surface area

36
Q

Who would be a suitable candidate for triple or double pelvic osteotomy?

A

dogs with moderate hip laxity with an angle of reduction of less than 35 degrees on an ortolani test, painful hips, no or minimal osteoarthritis and young (between 4 and 8 months)

37
Q

What happens during a triple or double pelvic osteotomy?

A

pelvis is cut in two or three places freeing the acetabulum which is rotated 20 degree

38
Q

Which 3 places are cut during a triple or double pelvic ostetomy?

A

pubis, ischium and ileum

39
Q

What type of procedure is a femoral neck and head excision?

A

salvage surgery

40
Q

What happens during a femoral head and neck excisional surgery?

A

femoralhead and neck removed to allow pseudoarthrosis to form

41
Q

What post-operative management is done after femoral head and neck excision surgery?

A

rapid return to exercise, physiotherapy after sutures removed

42
Q

What complications can occur after a triple or double pelvic osteotomy?

A

screw pullout or screw breakage

43
Q

What is the aim for total hip replacement?

A

pain relief and high levelfunction

44
Q

What are the indications for total hip replacement?

A

hip arthritis and hip dysplasia

45
Q

What is the success rate for cemented total hip replacement?

A

90-95%

46
Q

Why are cemented THR hard to revise?

A

cement has to be chipped away or osteotomsation of the femur to retrieve all foreign material

47
Q

What are examples of cemented systems for THR?

A

bardet,new generation devices

48
Q

What are examples of non-cemented systems for THR?

A

biomedtrix BFX, zurich, helica

49
Q

What happens in a non-cemented THR?

A

acetabulum is reamed out to fit a new femoral head

50
Q

What complications can arise from a non-cemented total hip replacement?

A

aspetic and septic loosening,fracture and neurological

51
Q

What is the zurich ceementless system? (KYON)

A

interlocking screws used

52
Q

What are the advantages of the kyon system?

A

easier to revise as no cement, less chance of subsidence due to locking system

53
Q

What is the helica hip?

A

femoral neck is preserved as the implant and is screwed into the bone

54
Q

What complciations can arise from total hip replacements?

A

fracture, loosening, dislocation, infection, subsidence, cement granuloma, neurlogical, luxation, osteomyelitis,implant failure, sciatic neuropraxia

ACVN - SURGICAL NURSING (17 decks)

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