Term
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Definition
| -abnormal development of the coxofemoral joint |
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Term
| True or FAlse: Hip dysplasia is the most common disease of the coxofemoral joint. |
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Definition
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Term
| What is the primary etiology behind hip dysplasia? |
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Definition
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Term
| Describe the etiopathogenesis of hip dysplasia. |
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Definition
| -abnormal development of hip => axcessive joint laxity (subluxation) => OA |
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Term
| What are some environmental factors that can lead to hip dysplasia? |
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Definition
-rapid weight gain
-rapid growth
-excessive nutritional intake
-activity, flooring
-conformation: dec pelvic muscle mass |
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Term
| What is the etiopathogenesis of joint laxity? |
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Definition
-round ligament an djoint capsule
-permits subluxation of the femoral head
-greater laxity =greater damage
-laxity leads to stretching of the joint capsule = pain response |
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Term
| What can hip joint laxity cause damage to? |
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Definition
-cartilage
-can cause trabecular bone microfracture
-synovitis |
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Term
| What is the etiopathogenesis of OA? |
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Definition
-end stage result of chronic inflammation
-bone remodeling, synovial thickening, new bone formation |
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Term
| Which dogs are especially at risk for hip dysplasia? |
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Definition
-rapid growth
-large and giant breeds
-small breeds can also be affectd |
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Term
| Which cats are especially at risk for hip dysplasia? |
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Definition
| -main coon, persian, and Devon Rex |
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Term
| Is there a sex predilection with hip dysplasia? |
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Definition
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Term
| Is hip dysplasia more commonly bilateral or unilateral? |
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Definition
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Term
| Why is hip dysplasia considered a biphsic disease? |
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Definition
| -clinical signs overlap in different phases |
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Term
| What clinical signs do we see with hip dysplasia in animals less than 8m? |
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Definition
-abnormal gait: bunny hopping, asymmetric sitting, waddling
-mildly painful (unless subluxation is severe or OA has started) |
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Term
| What clinical signs do we see with hip dysplasia in animals at 6-12m? |
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Definition
-unilateral/bilateral hindlimb lameness
-difficulty moving
-exercise intolerance
-waddling/stiff gait
-thich muscle atrophy
-pain
-dec muscle mass |
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Term
| What clinical signs do we see with hip dysplasia in animals at 10-12m? |
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Definition
-significant functional improvement: dut to joint capsule fibrosis/tightening
-variable residual lameness |
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Term
| What is the clinical presentation of long-term hip dysplasia? |
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Definition
-lameness/stiffness: worse in morning and after exercise
-thich muscle atrophy
-hip pain +/- crepitus
-chronic/persistet
-lw-grade |
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Term
| What do we see on orthopedic exam of hip dysplasia? |
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Definition
-abnormal gait
-thich muscle atrophy
-pain with hip extension and abduction
-dec joint ROM
-instability
-crepitus/OA |
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Term
| How common is CCL rupture with dogs presenting for hip dysplasia? |
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Definition
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Term
| How do we differentiate hip dysplasia from lumbosacral dz on orthopedic exam? |
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Definition
-direct palpation should be done in lateral
-weakness due to neuro dz = CP deficits
-rectal palpation pain = LS dz
-hip extension
-elevate tail head pain = LS dz |
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Term
| HOw can we definitively diagnose hip dysplasia via palpation? |
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Definition
-Ortolani maneuver
-Passive subluxation
-Also: Barlow test and Barden test |
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Term
| What is the Ortolani maneuver? |
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Definition
-force femur to subluxate and then evaluate the angle of reduction
-UNDER SEDATION |
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Term
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Definition
-force femur to subluxate and evaluate the angle of subluxation
-UNDER SEDATION |
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Term
| What is the Barden test? Why is it less commonly used to diagnose hip dysplasia? |
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Definition
-laterally displace the femur
-highly subjective |
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Term
| Why might you not get a clunk with the Ortolani maneuver when hip dysplasia is highly suspected? |
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Definition
-hip is normal
-shallow acetabulum
-severe OA
-user error |
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Term
| Describe the Orthopedic Foundation for Animals in terms of rads for hip dysplasia. |
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Definition
-evaluates passive laxity
-works at 2y of age
-Normal hip: excellent, good, fair, borderline
-Dysplastic hip: mild, moderate, severe |
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Term
| Describe the PennHip Distraction Index for hip dysplasia. |
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Definition
-evaluates laxity via passive distraction
-works at 16w of age
-grade scale: 0-1 )0= normal & 1 = laxity 100%) |
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Term
| which radiographic view is most useful for hip dysplasia? |
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Definition
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Term
| What is the ideal acetabular coverage of hte head of the femur on rads? |
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Definition
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Term
| What changes to the bones are we looking for on rads suspecting hip dysplasia? |
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Definition
-dec acetabular coverage
-acetabular subchondral bone sclerosis
-acetabular shallowing
-femoral head flattening
-femoral neck thickening
-osteopytisis
-enthesiophytosis |
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Term
| What is the earliest sign of OA that can be seen on rds? |
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Definition
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Term
| Why do we not commonly use CT/MRI for hip dysplasia? |
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Definition
| -no advantage and it is costly |
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Term
| Why would we perform arthrocentesis on a hip dysplasia case? |
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Definition
| -to rule out infectious or neopalstic diseases |
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Term
| Why would we use arthroscopy on a hip dysplasia case? |
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Definition
-rarely done
-useful to eval for articular lesions prior to TPO |
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Term
| What are the patient factors that affect our course of treatment for hip dysplasia? |
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Definition
-age
-quality of lige
-purpose of the animal
-activity level |
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Term
| Is medical or surgical management our go-to for hip dysplasia? |
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Definition
| -medical management is always better b/c surgery is a salvage procedure |
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Term
| What are the treatment goals for hip dysplasia? |
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Definition
-prevention of articular damage leadint to development of OA
-restoration of joint function
-improve patient comfort |
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Term
| Describe medical management of hip dysplasia. |
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Definition
-treat OA
-maximize until patient becomes refractory or muscle mass begins to siginifantly decrease |
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Term
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Definition
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Term
| Why would we perform a Juvenile Pubic Symphysiodesis (JPS)? |
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Definition
| -prophylaxis of hip dysplasia |
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Term
| What is the goal of juvenile pubic symphysiodesis? |
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Definition
| -to inc femoral head coverage by acetabulum via stopping pubic symphysis growth |
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Term
| At which age do we perform juvenile pubic sympydiodesis? |
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Definition
-12-16 weeds of age
-can do up to 24w |
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Term
| What is the expected outcome of a juvenile pubic symphysiodesis? |
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Definition
-dec OA progression rate
-improved joint congruency |
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Term
| Why would we perform a triple pelvic osteotomy (TPO)? |
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Definition
| -prevention or palliation of hip dysplasia |
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Term
| What is the goal of triple pelvic osteotomy? |
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Definition
| -to inc femoral head coverage by rotatin the acetabulum |
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Term
| How do we perform a triple pelvic osteotomy? |
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Definition
| -cut the pelvis in 3 places: ilial body, pubis, ischium |
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Term
| At what age do we perform triple pelvic osteotomy? |
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Definition
| -perior to 10-12m when they are skeletally immature |
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Term
| What are the criteria of triple pelvic osteotomy? |
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Definition
-laxity present but NO evidence of OA (angle of reduction should not exceed 20-30 degrees)
-mostly for medium/large breeds |
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Term
| What is the success rate of triple pelvic osteotomy? |
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Definition
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Term
| What is the outcome of triple pelvic osteotomy? |
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Definition
| -OA continues to progress but slower rate |
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Term
| Why would we perform a total hip arthroplasty? |
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Definition
| -salvage of hip dysplasia |
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Term
| What is the goal of a total hip arthroplasty? |
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Definition
| -replace end-stage joint disease with a prosthetic joint |
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Term
| Who is a candidate for total hip arthroplasty? |
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Definition
| -patient with which other treatments have failed |
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Term
| What is the success rate of total hip arthroscopy? |
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Definition
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Term
| What is the outcome of total hip arthroplasty? |
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Definition
-obtain near-normal biomechanics
-prmpt return to function |
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Term
| What is the major downfall of total hip arthroplasty? |
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Definition
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Term
| Why would we perform a femoral head and neck ostectomy? |
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Definition
| -salvage procedure for hip dysplasia |
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Term
| What is the goal of a femoral heand and neck ostectomy? |
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Definition
| -remove pain from diseased joint by excising the joint |
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Term
| Who is a candidate for femoral heand and neck ostectomy? |
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Definition
| -patient with which treatment options have failed |
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Term
| Is a FHO or THR better for the patient? Which is more common? |
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Definition
-THR
-FHO is mroe common b/c cheap and easy |
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Term
| How can you improve the outcome of FHO? |
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Definition
-ensure adequate muscle mass is present
-begin aggressive rehabilitation program immediately |
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