DL: HL lameness Flashcards Preview

Locomotor > DL: HL lameness > Flashcards

Flashcards in DL: HL lameness Deck (26)
Loading flashcards...

Describe the motion of the medial tarsal joints

low motion


Define DLPMO

dorsolateral-palmaromedial oblique


Define DMPLO

Dorsomedial-plantolateral oblique


What is the high motion joint of the tarsus?

tarso-crucal joint


What is the small tarsal joint prone to?

OA (spavin)


What is present on dorsal aspect of hock?

tertius and tibialis cranialis


How strng are tendon sutures?

very weak


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

Kissing spines
Intervertebral facet joint OA
Rib fracture


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?

trochlear groove


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
- Neoplasia


Tx - CCLdz

Extracapsular/ lateral fabellar suture
Other types of tibial plateau levelling sx – cr closing wedge osteotomy/ CWO, TTO, TTA
Intracapsular stabilisation
Most dogs will improve with time but it will take a long time
Reported that dogs under 15kg and cats do better with conservative managment