Unit 2: 3 - Hip Dysplasia Flashcards
Hip dysplasia is a _____ disease in dogs.
developmental
Hip dysplasia is characterized by hip _____ and OA is _____.
laxity, secondary
What % of bulldogs are dysplastic?
>70%
What muscles are secondary stabilizers of the hip joint?
Iliopsoas, pectineus, adductor
What causes the pain in CHD in young, rapidly growing large breeds?
laxity
What causes the pain in CHD in middle-age to older large breeds?
secondary OA
What are 6 CS associated with CHD?
- Decreased activity
- Difficulty rising
- Reluctance to run or climb stairs
- Bunny-hopping gait
- Narrowed stance
- Hyperextended hocks
Hip pain will result from the hip/leg being in what conformation?
Extended/abducted
What method is used to assess hip laxity?
Ortolani sign
What is an ortolani sign?
Maneuver to elicit hip subluxation and reduction (i.e. laxity); requires sedation to properly test
Positive = never normal = CHD
How is Ortolani assessed?
ADDuct stifle & use stifle as handle –> push femur towards spine –> apply light pressure on greater trochanter –> “POP” = positive Ortolani
What is an advantage to assessing Ortolani in dorsal recumbency?
Can assess quality of reduction and symmetry
T/F: Positioning is not important for radiographic assessment of CHD
False; it is CRITICAL
What 3 things are needed for radiographic assessment of CHD?
- Straight pelvis
- Femurs extended fully
- Femurs straight, not rotated (patella in center groove, fabellae bisected)
What are 3 radiographic signs that the patient has CHD?
- < 50% femoral head coverage
- Congruency of craniolateral joint
- Dorsal acetabular rim wear
What are 3 radiographic signs that a parient has secondary OA due to CHD?
- Morgan’s line (femoral neck thickening with periarticular new bone formation)
- Acetabular infilling
- Subchondral sclerosis
What are the PennHIP radiograph guidelines?
3 views:
- Distracted = laxity
- Compression = “goodness of fit”
- Hip extended = evaluate for OA
When can PennHIP rads be taken?
As early as 16 weeks of age
What are 4 ways to medically manage CHD?
- Weight management
- Exercise moderation
- Chondroprotectives
- Pain control (NSAIDs)
What are 4 ways to surgically manage CHD?
- Juvenile pubic symphysiodesis (JPS)
- Triple pelvic osteotomy
- Femoral head and neck excision
- Total hip replacement
What management route should be taken in a patient that is not showing CS for CHD?
Weight control, chondroprotectives, monitor
What management route should be taken in a patient that is showing CS for CHD?
NSAIDs, exercise moderation, weight control, chondroprotectives
What management route should be taken if a patient that was already showing clinical signs does not improve with medical management?
Surgery
What characteristics does a good canditate for TPO have?
- 5-10 months old
- Minimal or no radiographic evidence of OA
- Good femoral head capture (Ortolani)
An FHO is a _____ procedure.
salvage
What size animal can have an FHO?
Any size dog or cat, but there is a more predictable otucome for dogs < 40#
What will the gait look like after an FHO?
It will always be abnormal
What characteristics does a good THR candidate have?
Sole problem is HD/OA:
- NO neuro disease
- NO neoplasia
- NO CLL rupture
- NO infections
What is the most likely complication from a THR?
Infection
(In general complications from a THR are uncommon but serious)
