Flashcards in DL: HL lameness Deck (26)
Describe the motion of the medial tarsal joints
What is the high motion joint of the tarsus?
What is the small tarsal joint prone to?
What is present on dorsal aspect of hock?
tertius and tibialis cranialis
How strng are tendon sutures?
When is it better to use a 2x locking loop than a 3-loop pulley tendon suture?
better in tendons that are flatters
What are the 2 most important things for tendon repair?
repair + protect
Define/refine back pain in horses
can be primary or secondary to HL problem. only most severe cases show pain
Define kissing spines
overriding dorsal spinous processes with a boney reaction b/w these
Ddx - back pain in horse
Intervertebral facet joint OA
How do you make a definitive diagnosis of kissing spines?
Radiographic appearance strongly suggestive of kissing spines
Diagnostic analgesia definitive
Gamma scintigraphy supportive
Tx - kissing spines
Intra-spinous process steroid meds (test med as often not entirely sure)
Dorsal spinous resection – several techniques (when convinced of lesion location)
Interspinous ligament transection (new sx, controversial)
What does a flexed stifle radiograph show?
Tx - patella luxation (canine)
- Sx correction (move patella back into correct position and ensure trochlear groove deep enough to hold it)
- tibial transposition
- trochlear sulcoplasty
- lateral soft tissue imbrication
- medial soft tissue release
- distal femoral osteotomy (straighten out bones themselves)
Px - canine patella luxation
Good if sx succes and patella remains in trochlear groove
Outline canine patella luxation grading.
1.) manually patella can be pushed out but immediately reduces, no crepitus, stifle flexion/extension is in straight line with no abduction of the hock
2.) patella spontaneously and frequently luxates at times but remains in trochlear groove predominantly, many live with this for years but chronic causes erosion of AC (patella and prox medial lip crepitus)
3.) patella resides out of trochlear groove predominantly, deviation of tibial crest between 30 and 50 degrees from cr/cd plane, trochlear flat/shallow
4.) tibia twisted and tibial crest deviation of 50 to 90 degrees, patella permanently luxated, trochlea absent or even convex, limb carried or animal moves in a crouched position, with limb flexed
Describe laterally luxating patella in horses
’normal’ in shetlands (can be secondary to hip has been displaced and mm not working properly)
Describe upward fixation of patella
common, young animals, associated with mm weakness, best initial management = exercise, if persistent / permanent = medial patella ligament desmotomy (danger of apical patella fragmentation)
Contrast is that in dogs it will be MEDIAL
Common causes of stifle swelling
- adult horse: meniscal tears
- young: osteochondrosis
Outline meniscal tears in horses
Increasingly recognised cause of HL lameness in horse
Medial and lateral menisci, medial more frequently affected
Lameness – moderate to severe
Palpation - FT (and FP) joint distension. Palpate medial meniscus displacement
Imaging – radiograph, ultrasound, arthroscopy (combination of all 3)
Assess position of meniscus – prolapse important for stability and prognosis
List orthobiologics that may be used in equine meniscal ligament damage
stems cells, PRP, bone marrow aspirate concentrate
Px - equine meniscal injury
Over 50% horses with meniscal injury return to athletic use. With severe tears extending beneath femoral condyle + concurrent OA, px is considerably poorer
Ddx - CCLR
- CCL dz/R +/- meniscal injury (a degenerative disease hence why at top of ddx list)
- Other ligament instability (collaterals)
- OCD of femoral condyle
- Patella luxation
- Septic arthritis