Ortho 3

Question 1

why do dogs suffer from hip dysplasia? like what are the causes of hip dysplasia?

Answer 1

• genetics + environment
• hip laxity (primary risk factor for OA in all breeds)
• subluxation early in life
• varying degrees of shallow acetabulum and flattening of the femoral head

Question 2

what is the inevitable sequela of untreated hip dysplasia?

how does this potentially impact quality of life?

Answer 2

osteoarthritis

lowers quality of life

Question 3

hip dysplasia is a _____ condition. explain what that means for your patient in terms of expected progression of the disease.

Answer 3

developmental

hips are normal at birth (not congenital)

developing at a young age and progresses at they grow, causing more problems later on in life

Question 4

what are the typical C/S of hip dysplasia (including stage of disease)

Answer 4

• large/giant breed dogs
• not sight hounds!

juvenile (severe form):
- 5-12 mo
- sudden onset uni or bilateral lameness, bunny hopping, difficulty rising after rest
- severe hip joint laxity
- may improve with time

chronic form:
- variable onset in mature animal
- C/S related to pain from DJD
- may have sudden onset but typically insidious or chronic
- uni or bilateral lameness, difficulty rising, stiff pelvic limbs, exercise intolerance

Question 5

what diagnostic tests should you perform to confirm a diagnosis of hip dysplasia?

Answer 5

Ortolani test
- puppy, under anesthesia
- positive = hip dysplasia
- positive does not condemn to OA, and negative does not guarantee normal hips

rads: hip extended view, neutral position (PennHIP - you must send in rads) - you must be certified to do these

Question 6

what are the treatment options available for hip displasia?

Answer 6

medical - all dogs need this!
- reduce pain
- nutritional
- exercise mod
- NSAIDs

surgical:
- prophylactic - for skeletally immature, no secondary OA, prevent development of secondary OA (juvenile pubic synphysiodesis, pelvic osteotomy double or triple)
- salvage - >1yo with OA, eliminate pain from secondary OA (femoral head and neck excision, total hip arthroplasty)

Question 7

when evaluating a patient with suspected hip luxation following trauma, what must a clinician remain mindful of?

Answer 7

injuries to other body systems (bc trauma)

Question 8

what 2 positions of hip luxation are possible? which is most common? what are the associated C/S of each?

Answer 8

craniodorsal (most common):
- pain, lameness, external rotation & adduction, apparent shortening of limb

ventral:
- pain, lameness, internal rotation & abduction, apparent lengthening of limb

Question 9

how is hip luxation diagnosed?

Answer 9

rads to confirm luxation, determine direction, evaluate for other abnormalities

VD and lateral views

Question 10

does the approach for closed hip reduction differ depending on direction of luxation? is the associated long term outcome different depending on the direction of luxation?

Answer 10

ventral has better long term outcome with closed than craniodorsal

CD lux: Elmer sling
V lux: hobbles

Question 11

what are the surgical (open reduction) options for treatment of hip luxation? do the expected outcomes of these differ?

Answer 11

• capsulorrhaphy
• prosthetic capsule
• toggle-rod stabilization
• FHNE/FHO
• total hip arthroplasty