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Orthopaedics (SA) > Stifle > Flashcards

Stifle Flashcards

1
Q

What does TPLO stand for? What is it used for?

A

Tibial plateau levelling osteotomy

Periarticular technique used to repair crania cruciate ligament rupture

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2
Q

What does TTA stand for? What is it used for?

A

Tibial tuberosity advancement

Periarticular technique used to repair cranial cruciate ligament rupture

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3
Q

How can stifle conditions be diagnosed?

A

History and clinical signs
Radiography and other imaging
Arthrocentesis
Diagnostic analgesia

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4
Q

Give examples of developmental conditions of the stifle

A

Osteochondrosis
Growth disturbances (genu valgum)
Patella luxation

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5
Q

What is genu valgum?

A

Knees angled to touch each other instead of being straight

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6
Q

Give examples of acquired conditions of the stifle

A

Cruciate disease
Osteoarthritis
Immune-mediated arthritis
Neoplasia

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7
Q

What are the causes of cranial cruciate ligament (CCL) rupture?

A

Disease or degeneration in older dogs (+ minor trauma)
Young large breed dogs
Trauma = least common

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8
Q

What breeds are predisposed to CCL rupture?

A

Older dogs = Lab, Terriers

Young large breed dogs = Great Dane, Bull Mastiff

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9
Q

What diseases/degenerations can cause cranial cruciate ligament rupture?

A 
Increased collagen metabolism (in predisposed breeds)
Increased joint laxity
Narrowed intercondylar notches
Sloping angle of tibial plateau
Immune mediated disease
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10
Q

What are the clinical signs of cranial cruciate ligament (CCL) rupture?

A

Chronic/acute onset of HL lameness
Leg carried flexed (‘toe touching’
Stifle effusion - patellar ligament
Medial buttress and OA (if chronic)

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11
Q

What is a medial buttress?

A

Firm swelling on medial aspect of proximal tibia

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12
Q

What 2 tests can be used to test the integrity of the CCL?

A

Tibial compression test (if torn CCL, tibial tuberosity with move cranial when hock flexed)
Cranial drawer test (moving joint laterally - should have little movement)

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13
Q

How is CCL tear/ruptured diagnosed?

A

Clinical exam and history - v important
Radiography
Arthrocentesis
MRI

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14
Q

What are the treatment options of CCL tears/rupture?

A

Conservative - restricted exercise and analgesia (if <15kg)

Surgery - intracapsular, extracapsular or periarticular (TPLO or TTA)

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15
Q

What is an example of an intracapsular technique to repair the CLL?

A

Over the top (OTT)

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16
Q

What are examples of periarticular techniques used to repair the CLL?

A

TTA - tibial tuberosity advancement

TPLO - tibial plateau levelling osteotomy

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17
Q

After cruciate surgery, when should the patient re-examined?

A

Re-examine at 4-6 weeks and again at 12 weeks

Progress x-rays for osteotomies at 8 wks

18
Q

What are potential complications of cruciate surgery?

A

Infection

Menisci tears

19
Q

Are meniscal injuries usually medial or lateral?

A

Medial
(‘Bucket handle’ caudal pole - most common)
Can be iatrogenic (surgery) or later

20
Q

What are the treatment options for meniscal injuries?

A

Conservative - 4-6 weeks

Surgical removal of meniscus (if persistently lame)

21
Q

Is patellar luxation more common medially or laterally?

A

Medial

22
Q

What can cause patellar luxation?

A

Trauma
Congenital - predisposed breeds
Developmental problems- malalignment of quadriceps

23
Q

Patellar lunation is more common in what size dogs

A

Toy breeds

Large breeds

24
Q

Can gets get patellar luxation?

A

Yes - often asymptomatic

25
Q

What are the 4 grades of patellar luxation?

A

Grade 1 = intermittent patellar luxation, reduction immediate
Grade 2 = frequent/spontaneous luxation, reduction not always immediate, skipping
Grade 3 = permanent luxation, reduction possible but reluxates
Grade 4 = permanent luxation, reduction not possible

26
Q

How is patellar lunation diagnosed?

A

History
Clinical signs
Radiography

27
Q

What are the treatment options for patellar lunation?

A

Conservative (if intermittent clinical signs) - restricted, controlled exercise and NSAIDs
Surgery (if recurrent clinical signs) - many techniques

28
Q

What surgery can be done to correct patellar luxation?

A

Wedge or block trochleoplasty

Many techniques

29
Q

What breed is predisposed to osteochondrosis? Which sex?

A

Lab retrievers

Males > females

30
Q

How common is osteochondrosis?

A

Not very common

31
Q

What location in the HL is osteochondrosis most likely to be found?

A

Lateral or medial femoral condyle

Articular surface

32
Q

What are the clinical signs of osteochondrosis?

A

Lameness from 5 months old
Bilateral crouching gait
Joint effusion and discomfort upon palpation

33
Q

How is osteochondrosis diagnosed?

A

History
Clinical signs
Radiography

34
Q

How is rupture of the collateral ligaments diagnosed?

A 
Abnormal joint movement in medial or lateral direction
Stress radiographs (take contralateral limb to check for normality) - widening of joint space
35
Q

How is rupture of the collateral ligaments treated?

A

Parapatellar approach to affected side

Primary repair of ligament with screws and washers

36
Q

Multiple ligament injuries are uncommon, but are usually seen in what type of dogs?

A

Working dogs

37
Q

How are multiple ligament injuries diagnosed?

A

Clinical exam

Stress radiography

38
Q

How are multiple ligament injuries treated? What is the prognosis?

A

Repair of CCL and collateral ligaments
Removal of damaged meniscus and joint capsule
Prognosis = good

39
Q

Is stifle osteoarthritis common?

A

Yes

Secondary to CCL rupture

40
Q

Give an example of a neoplasia seen in the stifle of larger breed dogs

A

Osteosarcoma

Orthopaedics (SA) (10 decks)

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