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Surgery Exam 2 > Lecture 2: Hip Dysplasia/Sx Management > Flashcards

Lecture 2: Hip Dysplasia/Sx Management Flashcards

1
Q

What do you do if a dog is clinically normal, but radiographically abnormal?

A

You dont do shit;

but tell owner to keep an eye for early signs of OA/hip dysplasia

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2
Q

What is CHD?

A

canine hip dysplasia
developmental diseas of dogs
characterized by hip laxity/loosening in the hips
No cure

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3
Q

T/F

CHD is not congenital

A

TRUE

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4
Q

What are the factors that contribute to CHD?

A

genetics/hereditary factors

environment

rapid growth

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5
Q

How does the ligament of femoral head contribute to joint stability?

A

connects the head of the femur to teh acetabulum

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6
Q

How does joint fluid contribute to CHD?

A

increased fluid = increased pressure = pushes the head out of acetabulum

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7
Q

How does the joint capsule contribute to CHD prevention?

A

stabilizer of the coxofemoral joint
eventual thickening may help prevent CHD
painful as juvenile but with time thickening will resolve

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8
Q

Muscles act as _______ of the joint

A

secondary stabilizers

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9
Q

How would rapid growth of an animal contribute to CHD?

A

rapid growth may result in disparity of muscle:bone (bone grows faster

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10
Q

What 3 muscle groups contribute to hip stability?

A

iliopsoas, pectineus, adductor

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11
Q

What information is important to receive from owners to initiate tx of CHD?

A

at least orthopedic exam /radiographs

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12
Q

What is the common signalment of a young dog with CHD?

A

young, rapidly growing, large breed

painful from laxity results in:
synovitis
cartialge wear/tear
possible microfracture of acetabular bone

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13
Q

What is the common signalment of older/middle aged dogs with CHD?

A

usually painful from secondary OA

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14
Q

What are the clinical signs of CHD?

A 
decreased acitvity
difficulty rising
reluctant to run or climb stairs
bunny hop gait
narrowed stance
hyperextened hocks
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15
Q

What would you expect to find on a physical exam of a dog with CHD?

A 
Muscle atrophy
hip pain on extension
decreased hip ROM
palpable crepetation
symmetrical HL lamness
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16
Q

What is an Ortolani sign?

A

maneuver to elicit hip subluxation and reduction ie laxity

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17
Q

What is the technique to pdx an ortolani sign?

A

adduct stifle, lift greater trochanter, push femur dorsally, apply light pressure on greater trochanter until it pops

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18
Q

Which has a better prognosis, a sharp pop, or a soft-mushy like movement wiht regards to Ortolani signs?

A

Pop is better

mushy has worse prognosis

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19
Q

Whhat is the most important thing in regards to radiographs?

A

POSITIONING

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20
Q

What position do you want the dog to bein to take radiographs for CHD?

A

need V-D

straight pelvis

femurs fully extended
femurs straight not rotated

patella in center of trochlear groove
fabellae bisected by medial and lateral femur cortices

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21
Q

Hip dysplasia is classified as __% of femoral coverage by _____

A

50%

acetabulum… DUH

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22
Q

How do you tell if there is 50% coverage?

A

make circle around the headm ID cneter, then draw line cranial to caudal margins of acetabulum and center

Pretty much just dont be an idiot

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23
Q

What are you looking for on a radiograph to determine CHD?

A

well besides 50% coverage…
secondary OA- morgans line/line for osteophytes
periarticular bone formation on femoral neck
acetabular infilling
subchondral bone formation

24
Q

What are OFA radiographs?

A

Dont really seem important-

need VD pelvis only

grades from excellent- severe dysplasia

25
Q

What 3 veiws do you need for PennHIP radiographs? and what do they tell you?

A

distracted view- laxity

compression view- goodness of fit

hip extended view- evaluate for OA

26
Q

What is the distraction index?

A

measure of hip laxity 0-1

distance the head can be displaced from the acetabulum

27
Q

What does the DI score indicate?

A

near 0 = little laxity

1 = high degree of laxity

less than .3 is considered ‘normal’

HD unlikely to occur

28
Q

What are the 2 tx options for HD?

A

medical management

surgery!

29
Q

what are the surgical options to tx HD?

A

JPS
TPO
Femoral Head/Neck excision
Total hip replacement

30
Q

What must you consider when selecting surgery technique?

A

age
secondary OA changes
desired outcome

31
Q

What is JPS?

A

Juvenile Pubic Symphysiodesis

elctrocautery of the ventral portion of pubic symphysis

32
Q

What is the result of JPS?

A

stops growth ventrally

continues dorsal growth- more coverage of the femoral head

33
Q

When is it best to perform JPS?

A

12-16 weeks of age

34
Q

What is the potential draw back of JPS?

A

future breeding could be issue

recommend spay/neuter, because will not be able to tell older dog had procedure

35
Q

What is the other Sx option for an immature dog with HD?

A

Triple pelvic osteotomy

36
Q

What is a TPO?

A

osteotomy of pubis, ischium and ilium

37
Q

What does a TPO result in?

A

ventral rotation of acetabular segment-> more dorsal coverage of femoral head

38
Q

Candidates for TPO?

A

5-10 months old
minimal or no radiographic evidence of OA
good femoral head capture-> crisp pop not mushy

39
Q

T/F

It is recommend to wait linger before Sx with TPO because many dogs will spontaneously improve after skeletal maturation

A

FALSE

EARLY is recommended because OA will develop fast, the second part is true

40
Q

Are bilateral TPOs common?

A

YES, however stagger Sx

41
Q

What are some complications with TPO?

A

omplant loosening
narrowed pelvis
urethral obstruction (creating a smaller opening)
femoral neck impingement

42
Q

What is a FHO?

A

Femoral head and neck excision

salvage procedure

43
Q

T/F

there will aways be a gait abnormality post op for FHO, but a more predictable outcome occurs when preformed in dogs less than 40lbs

A

TRUE

44
Q

____ post op FHO is extremely important bc normal fx is hard to regain

A

Physical rehabilitation

45
Q

What is teh second salvage procedure to Sx repair old dogs with HD?

A

THR- total hip replacement

46
Q

T/F

Total hip replacements will result consistently in 80% of animals regaining original function

A

FALSE?

Kind of a shitty question on my part, but THR gives full range of motion, so you could extrapolate and assume those animals regain full fx?

47
Q

What are the 2 types of THR?

A

cementless and cemented systems

48
Q

T/F

THR and FHO both typically require bilateral operation

A

FALSE

THR usually unilateral because it is comfortable/easier recovery

49
Q

Who are candidates for THR?

A

only problem is HD/OA

No neuro issues

No neoplasia

No CCL injury

No infections

50
Q

T/F

Complications with THR are uncommon, and are not serious issue

A

FALSE

uncommon but very serious

51
Q

What are the THR complications?

A

infection

luxation

loosening

femoral fx affected

52
Q

T/F

HD is usually caused by a singular event

A

FALSE

multifactorial

53
Q

T/F

All dogs with HD will show signs

A

FALSE

54
Q

T/F

Medical management is usually unsuccessful in older dogs, there for it is in the best interest of the patient/client to recommend Sx immediately

A

FALSE

Medication is always first

55
Q

What is a limiting factor for the OFA hip radiographs?

A

Have to be at least 2 years old

Surgery Exam 2 (8 decks)

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