MSK 4 Ligaments Tendons Flashcards
What are the three parts of the Calcaneal tendon?
- Gastrocnemius – paired tendons
- Combined tendon of the Semitendinosis, gracilus and biceps femoris m.
- Superficial digital flexor m.
What are the clinical signs of a full rupture of the Calcaneal tendon?
- Sudden severe pelvic limb lameness
- Plantigrade stance
- Hyperflexed stifle/hock
- May not be painful to palpate
- Possible laceration or bruise swelling over the area
What are the clinical signs of a partial rupture of the Calcaneal tendon?
- Digits flexed
- Partial plantigrade stance
- Painful and swollen
- History of chronic lameness that worsens
What are the ideal properties of suture to repair tendons?
- Long absorbing or non-absorbing monofilament
- 0 or 1 PDS or Nylon
- Long acting to withstand the long healing period of tendons
List the four tendon repair suture patterns.
- Locking loop (FLAT)
- 3 loop pulley (ROUND)
- Krakow
- Double locking loop
- Double Cross Lock
- Triple circle lock
- Modified Tang
- Simple horizontal mattresses superficially
What is the recommended post-operative management for tendon repair?
- Protected bandage with no load bearing for the first few weeks
- At 3 weeks, bandage off and very restricted movement
- At 6 weeks, allow controlled exercise
True or False: By 1 year, the tendon will have 100% of its original healing strength.
False
What are the three main phases of tendon healing?
- Inflammatory (1 week)
- Proliferative (few weeks)
- Remodeling phase (many months)
What is the most likely cause of septic arthritis?
Recent surgery to a joint or pre-existing joint disease (e.g., OA)
What are the typical cytological features of joint fluid in an infected joint?
- Turbid fluid
- Increased cell counts (~ >50 x 10^9)
- Mononuclear cells ~ 1-10%
- Neutrophils ~ 90% with toxic changes, intracellular bacteria
List common bacterial isolates associated with septic arthritis in dogs.
- Staphylococcus intermedius
- Staphylococcus aureus
- Streptococci spp.
- Pasteurella multocida (CATS)
- Bacteroides spp. (CATS)
How can bacteria be isolated for culture and sensitivity testing?
- Arthrocentesis using aseptic technique
- Use blood culture medium to store synovial fluid
- Synovial tissue biopsy and culture if clinically justified
What are the medical treatments for septic arthritis?
- Arthrocentesis for fluid culture
- Systemic broad-spectrum antibiotics
- Minimum treatment duration of 28 days
- Repeat arthrocentesis to check cell count
What are the surgical treatments for septic arthritis?
- Joint irrigation
- Local antibiotic infiltration
- Arthroscopic inspection if gross contamination
- Synovial resection if needed
What is the overall prognosis for a 16-week-old puppy with an elbow joint infection?
- Improvement expected in 24-48 hours
- Infection resolved in 94% of cases
- Full recovery unlikely if pre-existing OA
What are the four aetiopathologies of canine osteoarthritis?
- Developmental disorders (secondary OA)
- Joint incongruence/instability (secondary OA)
- Trauma/Ligament injury (secondary OA)
- Idiopathic (primary OA)
List macroscopic changes seen in articular cartilage due to arthritis.
- Cartilage loss/ulceration/eburnation
- Osteophytes, enthesiophytes
- Fibrillation
- Thickened subchondral bone
What are the microscopic changes seen in articular cartilage due to arthritis?
- Extracellular matrix degrades
- Increased water content
- Chondrocytes proliferate/hypertrophy
- Vascular invasion through the tidemark
What are the mediators of arthritis?
- IL-1, IL-7, IL-18, TNF-a
- COX-2
- Reactive oxygen species
- Nitric oxide
What is the mechanism of action of NSAIDs?
Inhibit one or more steps in the metabolism of the arachidonic acid cascade and block prostaglandin synthesis.
What are potential adverse effects of NSAIDs?
- Gastric ulceration
- Renal perfusion issues
- Impaired platelet activity
Fill in the blank: The healing of a tendon with a minimal gap of less than ______ will have very little scar tissue.
[1mm]
What are the two main goals of tendon repair?
- Minimise/eliminate the gap
- Allow early loading to ensure correct collagen formation
Describe the initial phase of tendon healing.
Inflammatory phase where ends of tendons produce inflammatory products and neutrophils.