Ortho 2 Flashcards
what is the purpose of veterinary orthopedics?
to improve comfort and function
max, an overwieght 6yo golden, seems old and tires easily walks and seems old, he fails the sit test (sits to the side), stiff and slow to rise.
loss of muscle mass in the left thigh and a medial buttress of the left stifle. pain and crepitation on manipulation of the left stifle. positive cranial drawer test and positive tibial thrust.
differential?
CCLR!
the cranial cruciate ligament is made up of 2 fibers, a medial and a lateral. why is it so important to do the cranial drawer test in both flexion and extension?
the medial fiber tends to degenerate/tear first, and it is taut in both flexion and extension. the lateral fiber tends to degenerate/tear second, and it is only taut in extension only.
therefore, with a partial tear, there will be a positive cranial drawer test in flexion and negative in extension (apparently??? this makes no sense to me)
what is the cause of CCL rupture
we dont know, but it’s usually NOT trauma ! it is a degenerative condition with biologic and biomechanical factors. if it happens to one leg, it’s likely to happen in the other
why does the meniscus become damaged with CCL injury?
as the femur slides back and the tibia slides forward, the meniscus get pinched/compressed, especially the medial one
clinical signs of CCL tear?
lameness, pain, effusion, periarticular fibrosis, crepitation, instability, positive cranial drawer and tibial thrust, meniscal click
why are radiographs important for CCL tears?
to confirm diagnosis, rule out other causes of lameness, and to plan for surgery
what are some says to medically manage CCL tear?
weight loss!!!
exercise modification (low impact, high resistance only)
pain relief, NSAIDs
surgical treatment of CCL rupture includes:
extracapsular technique: simulating a fake CCL out of wire/suture, best for dogs less than 15kg
osteotomies/ostectomies: good for all sizes, first choice in dogs over 15kg. example: TPLO
surgical management of CCl tear MUST include what?
evaluation and treatment of the menicus
true or false: all animals need medical management
TRUE
clinical signs of patellar luxation?
failing the sit test, skipping gait, loss of muscle mass, joint effusion
what causes patellar luxation in dogs?
developmental medial luxations: toy breeds and large breeds
developmental lateral luxations: toy breeds only
describe stages 1-4 for patellar luxation
stage 1: in and wants to stay in, spontaneously reduces
stage 2: in the groove but can be luxated out and stays out
stage 3: out of the groove but can be manually moved back in
stage 4: it out and cannot be manually moved back in, trochlear ridge basically gone
what are the main three options for treating patellar luxation?
soft tissue procedures: RARELY used alone, you essentially release contracted tissue on the same side as the luxation and tighten structure on the opposite side of the luxation
groove reconstruction procedures: deepen the trochlear grove (sulcoplaty, chondroplasty, wedge recession trochleoplasty, block recession trochleoplasty)
limb alignment procedures: try to straightenthe limb
