SaSx FINAL - new material Flashcards
Hyaline/Articular cartilage
avascular
10% chondrocytes, 90% ECM
nutrition from synovial fluid
T/F: arthrotomy is preferred over athroscopy
FALSE
T/F: osteoarthritis is inflammatory joint disease
FALSE, will not see neutrophils
Describe diagnostic processes involved w/ osteoarthritis
rads - can suggest inflammation but thats it
CT - see specific bony changes, good for carpus + tarsus
MRI - see soft tissue changes
Bone scintigraphy - good to localize lameness, radioisotope has affinity for inflammation
Arthrocentesis - can differentiate inflammatory vs non inflammatory
Medical management of osteoarthritis
weight management is most important
exercise in moderation, rehab, omega 3s (anti-inflammatory + chondroprotectant), glucosamine/chondroitin
Pain management: NSAIDs - cox 1 and 2 are good but have GI + renal SE, new drug EP4 blocker (galaprant) spares stomach + kidney
Adaquan - replenishes prostaglandins
NO CORTICOSTEROIDS - depress chondrocyte metabolism, alter matrix, necrotic effect
What is osteochondrosis
disturbance in endochondral ossification, cartilage thickening, malnourished chondrocytes, clefts/fissures in cartilage at junction of calcified + non-calcified tissue, turn to defect, break off, OCD lesion
general Tx of osteochondrosis
if young, small defect or minimal lameness, can do rest diet + NSAIDs
otherwise,
arthroscopy to remove flap, joint lavage, debride bone w/ curette or shaver, heals w/ fibrocartilage (stimulated by bleeding)
Prognosis of joints with osteochondrosis
shoulder > stifle > elbow > tarsus
Location of osteochondrosis in joints
shoulder - early: flattening of subchondral bone of caudal humeral head, late: saucer shaped radiolucent area
Elbow - distal aspect of medial humeral condyle
Stifle - medial aspect of lateral femoral condyle (MC) or medial condyle
Tarsus - medial (MC) or lateral trochlear ridge of talus
Biceps brachii tendinopathy
anatomy - tendon runs from supraglenoid tubercle, through inter tubercular groove under transverse retinaculum and inserts on medial tuberosity of proximal radius
PE: weight bearing lameness, muscle atrophy, pain when shoulder flexed or elbow extended
Dx: rads to r/o other causes, arthroscopy best, MRI over/under interpret
Tx: acute - NSAIDs, 4-6w rest + PT - if no response, arthroscopic eval of joint to ensure other structures intact
- Tenotomy - cut tendon
- Tenodesis - cut + move to different location w/ screw
Px - sx: good to excellent, meds: good to poor
Shoulder instability
abnormal inc in range of motion, laxity on support structures, repetitive micro trauma, ~80% medial instability
poor response to rest + NSAIDs
inc abduction angle (compare w/ other leg)
Dx: arthroscopy
Tx: Hobbles if mild, moderate - arthroscopic radio frequency shrinkage via thermal insult, severe - Sx
Sx: medial glenohumeral ligament reconstruction, the velpeau sling (2-4w) then hobbles
Infraspinatus contracture
muscle shortening, not from active contraction
mm. replaced by fibrotic tissue, contraction secondary to necrosis
non-painful, non-weight bearing, external rotation of shoulder. + internal displacement of elbow
CS: characteristic posture
Tx: penectomy of infraspinatus tendon, release other capsular adhesions, PT
Px: excellent
Traumatic shoulder luxation
non-weight bearing, pain on palpation
medial MC, distal limb abducted
Tx: closed reduction (after rads to make sure no fractures), coaptation 2w (velpeau if medial, spica if lateral)
Sx if chronic, recurrent or unstable or if fractures
- simple arthrotomy to reduce, imbrication, glenohumeral lig reconstruction
Px: good to excellent, minor DJD over time
Congenital shoulder luxation
small breeds, young, usually medial + unilateral +/- glenoid dysplasia
PE: joint easily reduced + related, if glenoid dysplasia then can’t reduce, minimal pain
if normal glenoid - open reduction and GHL reconstruction, if glenoid dysplasia, salvage
3 salvage procedures of shoulder
arthrodesis, glenoid excision, amputation
