Surgical Treatment for Degenerative Arthropathies Flashcards
When should you use diagnostic arthroscopic Surgery?
-Joint like the stifle that are challenging to image
-When you need another angle
-When cases no longer respond to treatment
What are some surgical techniques for OA?
Lavage and examination, removal loose cartilage or fragments, stimulation fibrocartilage repair, remove diseased bone, cartilage resurfacing
What is a common reason to use fetlock arthroscopy in race horses?
Hyperextension injury and inflammation
Villonodular Synovitis - remove enlarged pad
What are structures are you investigating during stifle arthroscopy?
Cruciate ligament, menisci, meniscal ligament, large cartilage erosions and cartilage lesion not visible otherwise
If left alone how does cartilage repair occur?
It does not regenerate but instead creates fibrocartilage
What are the 3 types of repair?
Matrix flow, Intrinsic and Extrinsic
What is intrinsic repair?
limited repair in the cartilage
-Partial thickness, nonhealing and mild inflammatory response
-caused by limited mitotic ability of chondrocyte, ineffective collage and proteoglycan production
-Smooth out (no improve Longterm)
What is extrinsic repair?
Mesenchymal ingrowth below the subchondral plate
-Full thickness defect, deeper calcified cartilage layer, improve healing response
-Repair - mesenchymal tissue inflow from subchondral bone
-may microfracture to get vasculature there, more type 2 collagen
What is it called when you perform tissue transplantation for repair?
Mosaicplasty - autologus cartliage implantation
-Retrieve from femoral head, metacarpus or tarsus
How do you know you are dealing with end stage DJD?
When movement = pain
Which joints can be fused (arthrodesis) and still be athletic?
Distal Tarsal (DIT and TMT)
Pastern
Coffin
Which joints can be arthrodesed but for salvage?
Fetlock and Carpus
What are ways that a joint can be arthrodesed?
Injection, Laser, Drilling or Open (remove cartilage, plate, screws, bone graft)
How can you arthrodesis the distal tarsal joint?
-May ankylose on its own
-Surgical drill
-Laser
-MIA injection
How can you arthodes the pastern?
Hind better than front
-Surgical (plate, screws, casting)
-Will not ankylose on its own without hardware
