Hip dysplasia

Question 1

What are the multifactorial underlying processes that result in hip dysplasia?

Answer 1

!!!!Hip laxity!!!!

• Genetics, nutrition, skeletal development, environmental factors “epigenetics”
• Hip dysplasia and subsequent osteoarthritis are the clinical manifestations of the above
• Hip laxity–> poor joint congruence/subluxation abnormal hip development

Question 2

What is the normal coverage of the femoral head by the acetabulum?

Answer 2

50-60% coverage

Question 3

CCO- caudal lateral curvilinear osteophyte aka Morgan’s line, what is it?

Answer 3

Term used frequently to describe where the joint capsule attaches from pelvic side to femur circumferentially.

Question 4

Morgan line seen with some mineralization (white line) on rad, what does this indicate?

Answer 4

indicates joint laxity around femoral neck– predisposed to OA

Question 5

Have to be at least ____ years old to get OFA

Answer 5

2 yrs old

Question 6

PennHip:

Answer 6

stress rads to detect joint laxity, must be certified as a Dr to do this, more objective and accurate. Can be PREDICTIVE of the development of OA as early as 16 weeks old!!! only a measure of hip, not a certification process

Question 7

Penn hip can be predictive and used in pups as young as 16 weeks. T/F

Answer 7

True!!!!

Question 8

Penn hip:
DI of 0 means ?
DI of 1 means?

Answer 8

DI 0= no laxity

DI 1= severe laxity/luxated

Question 9

What is the most impt factor in development of arthritis?

Answer 9

Laxity!!!!!

Question 10

Passive laxity is best measured by what test?

Answer 10

PennHip

Question 11

what is “functional laxity”??

Answer 11

pathological form of laxity that occurs during weight bearing

Places abnormal forces on the joint surfaces leading to joint damage…. there is NOOOO current test for functional laxity

Question 12

What does Distraction Index mean?

Answer 12

Probability that the animal will develop OA as the animal ages, can be somewhat breed specific but generally a DI of more than 0.3 is considered susceptible for OA development

Question 13

Is none weight bearing lameness common in hip dysplasia p?

Answer 13

NOOOOO

Question 14

What are the plans of tx of hip dysplasia for immature dogs that are still growing?

Answer 14

Medical tx, TPO, JPS

Question 15

What are the plans for tx for mature dogs with OA?

Answer 15

Medical tx, THA, FHO

Question 16

What is the procedure that is done the most, and can be a preventative measure to decrease the development of arthritis but cannot prevent OA if already begun?

Answer 16

TPO- Triple pelvic osteotomy

Question 17

TPO characteristics-

Answer 17

ii. Ileum, ischium, and pubis are cut and pelvis is rotated so the femoral head is covered more
iii. Done in dogs 8-12 months of age
iv. Derived from studies done on kids, reorientation of the acetabulum

Question 18

Prognosis after TPO sx-

Answer 18

improved lameness in 92% of individuals and progression of OA is successfully delayed

Question 19

Fusion of the pubic symphysis by destruction of growth plate using electrocautery=

Answer 19

Juvenile Pubic Symphysiotomies (JPS)

Question 20

When is the best time to do sx for juv. pelvic symphysis?

Answer 20

less than 16 weeks (or 20 weeks in giant breeds), no benefits in animals more than 24 weeks of age

Question 21

What is the goal for the JPS sx?

Answer 21

destroy the growth plate of the ischium allows other sides of pelvis to grow but not the ischium
Not super invasive, neuter-like incision done

Less side effects than TPO, less equipment needed

Question 22

If JPS sx is so easy, without a lot of equipment needed, then why do we not do it more often?

Answer 22

usually the CHD is not found this early on in the puppy’s life

Question 23

FHO is usually done in _____ dogs, and relies of the formation of ______ which acts like a fake joint taking up space and is made up of scar tissues

Answer 23

smaller dogs; pseudoarthritis

Question 24

Total hip arthroplasty (THA) aka total hip replacement surgery is usually for ____ breeds, but can be performed on others too. When should we NOT do this surgery?

Answer 24

Larger breed dogs; Do not do this surgery if:

1. If patient has infection or cancer (infection because if the infection occurs, we have to remove alllll of the hardware and cannot do it all over again)
2. Cruciate disease
3. Neuro issues

Question 25

With THA, there is a ___% success rate, owner compliance is SUPERRR impt. If patient has bilateral hip issues, usually only doing one leg will provide them with enough relief

Answer 25

95%

Question 26

What is the medical/conservative management for CHD (canine hips dysplasia)?

Answer 26

OA disease modification meds, NSAIDS, Tylenol 4, PT, weight management, polyunsaturated FA

Question 27

What is Ortolani sign?

Answer 27

Ortolani’s sign is the palpable sensation of the femoral head slipping into the acetabulum. Ortolani described the accompanying sound as a click; it is more often thought of as a clunk nowadays, although audibility is by no means an essential requirement.