surgery of the elbow I

Question 1

arthrosis definition

Answer 1

denotes a joint but also degenerative disease of joint

Question 2

polyarthritis

Answer 2

inflammation affecting several joints

Question 3

osteoarthritis or osteoarthrosis

Answer 3

noninflammatory DJD characterized by articular cartilage degeneration, marginal bone hypertrophy (osteophytosis), and synovial mem changes

Question 4

ankylosis

Answer 4

joint fused after new bone production due to DJD

Question 5

synovial joints

Answer 5

joints lined with synovial membrane

Question 6

fibrous joints

Answer 6

connected with fibrous tissue allowing for little to no movement

Question 7

cartilaginous joints

Answer 7

connect with cartilage allowing for little to no movement

Question 8

arthroscopy

Answer 8

endoscope to examine joints

Question 9

arthrotomy

Answer 9

surgical exposure of joint

Question 10

arthroplasty

Answer 10

revision of joint structure

Question 11

arthrodesis

Answer 11

sx tx for joint fusion

Question 12

dysplasia

Answer 12

abnormal development of tissues, organs, cells

Question 13

what is the leading cause of forelimb lameness in dogs

Answer 13

canine elbow dysplasia

Question 14

breed dispositions for elbow dysplasia

Answer 14

polygenic trait with both hereditary and environmental influences

Question 15

why should breeding dogs with canine elbow dysplasia be discouraged

Answer 15

hereditary

Question 16

what does elbow dysplasia include (RED)

Answer 16

ocd, fragmented coronoid process, medial compartment disease, ununited anconeal process

Question 17

what is incomplete ossification of humeral condyle (RED)

Answer 17

another developmental disease of canine elbow, may cause similar signs and lead to fx of humeral condyle

Question 18

what is there strong evidence of in the etiology of elbow dysplasia (RED)

Answer 18

hereditary component

Question 19

what is loss of elbow ROM evidence of (RED)

Answer 19

evidence of DJD, immature lg dogs indicates presence of elbow dysplasia

Question 20

what is radiographic position essential for regarding elbow dysplasia (RED)

Answer 20

dx of subtle lesions and ddx

Question 21

are both elbows radiographed to dx elbow dysplasia? (RED)

Answer 21

yes

Question 22

what usually improves limb function with elbow dysplasia? (RED)

Answer 22

surgical removal of bone and cartilage pieces

Question 23

what is a fragmented coronoid process?

Answer 23

separation of small portion of medial coronoid process of ulna, may occur as osteonecrosis of coronoid or fissures within medial coronoid

Question 24

PE findings of FCP

Answer 24

may walk with shortened steps, symmetrical or asymmetrical muscle atrophy, joint effusion and periarticular soft tissue swelling

Question 25

describe shoulder manipulation during FCP PE

Answer 25

not flexed and extended during elbow manipulation - prevents mistaking shoulder pain for elbow pain

Question 26

what may be the earliest sign of FCP

Answer 26

pain on hyperextension of elbow

Question 27

what is the earliest radiographic sign of FCP

Answer 27

sclerosis of distal aspect of trochlear notch and blunting of medial coronoid process

Question 28

what is rarely seen on FCP radiographs?

Answer 28

visible fragments

Question 29

what is visible later in the process on FCP rads?

Answer 29

osteophytes with coronoid and anconeal processess

Question 30

how is FCP diagnosed on rads?

Answer 30

presence of osteoarthritis

Question 31

why are FCP rads difficult to evaluate

Answer 31

may have very subtle changes, occult elbow dysplasia, even in presence of significant arthrosis

Question 32

what is more accurate to ID FCP than rads?

Answer 32

CT

Question 33

what are advantages of CT for FCP over arthroscopy?

Answer 33

dx incomplete fragmentation of medial coronoid that does not reach cartilage surface

Question 34

what is the most valuable tool for diagnosis FCP

Answer 34

arthroscopy

Question 35

which disorders have strong evidence for hereditary components?

Answer 35

FCP and OCD

Question 36

why should we ALWAYS radiograph both elbows?

Answer 36

high frequency of bilateral disease

Question 37

what may improve function of limb?

Answer 37

sx removal of bone and cartilage pieces

Question 38

does surgical tx alter progression of DJD?

Answer 38

no

Question 39

if the elbow is incongruent, what may the dog require?

Answer 39

medical therapy post op

Question 40

who are candidates for surgery of FCP

Answer 40

young doggos

Question 41

what are advantages of arthroscopic tx of FCP

Answer 41

superior visualization and magnification of joint, less invasion, lower post op morbidity, greater opportunity for topical tx of osteoarthritic lesions

Question 42

if arthroscopy or arthrotomy fails to demonstrate a fragment, what is performed?

Answer 42

subtotal coronoidectomy

Question 43

what is described as treatment for FCP regarding the biceps insertion

Answer 43

release of biceps insertion on ulna

Question 44

what does the release of the ulnar insertion of biceps brachii m do for fcp

Answer 44

decrease transarticular forces between distal medial humeral condyle and medial coronoid process

Question 45

which open surgical technique offers good exposure for FCP

Answer 45

tenotomy of pronator teres m and incising medial collateral lig

Question 46

which open surgical technique for FCP preserves supporting tendons and ligs?

Answer 46

muscle splitting technique

Question 47

which open surgical technique for FCP offers best exposure?

Answer 47

osteotomy of medial epicondyle

Question 48

what is radial ulnar incongruence?

Answer 48

elevation of coronoid above level of radial head

Question 49

what is RUI the suggested cause of

Answer 49

fragmentation of MCP and medial compartment disease

Question 50

what causes increased forces across medial compartment?

Answer 50

asynchronous growth between radius and ulna

Question 51

PE findings of dogs with RUI

Answer 51

walk with shortened steps, symmetrical or asymmetrical muscle atrophy, joint effusion and periarticular soft tissue swelling

Question 52

how is incongruence of a joint investigated

Answer 52

plain film rads or CT

Question 53

where will MCP appear

Answer 53

proximal to radial head

Question 54

what is inaccurate for diagnosis of mild incongruity of RUI

Answer 54

routine medial lateral radiography

Question 55

what is more accurate in evaluating incongruence than rads?

Answer 55

CT

Question 56

what is surgical tx of RUI?

Answer 56

restore normal congruence between proximal articular surfaces of radius and ulna by shortening ulna or lengthening radius

Question 57

what is a segmental osteotomy?

Answer 57

in proximal 1/3 of ulna removing approximately 1/2cm of bone

Question 58

what is the angle of osteotomy for proximal ulnar segment osteotomy

Answer 58

caudoproximal to craniodistal and craniolateral to caudomedal

Question 59

describe distal ulnar segmental osteotomy

Answer 59

3 cm incision over lateral distal 1/3 of ulna, exposure diaphysis, isolate ulna with hohmann retractor, remove 5mm length section

Question 60

what aids in distal migration of ulna

Answer 60

elevation of interosseus ligament of ulna

Question 61

what does MCD refer to

Answer 61

mod to severe cartilage erosion limited to medial aspect of canine elbow joint

Question 62

which regions are commonly affected by MCD

Answer 62

medial portion of coronoid process, medial distal aspect of humeral condyle, medial most portion of radial head

Question 63

etiology of MCD

Answer 63

unknown, most likely mechanical overload or incongruity

Question 64

how is severity of cartilage loss of MCD graded?

Answer 64

modified outerbridge scale

Question 65

signalment of MCD dogs

Answer 65

large breed dogs, age of onset of dz process unknown

Question 66

MCD PE findings

Answer 66

bilateral lameness of forelimbs, shortened steps, symmetrical or asymmetrical m atrophy, joint swelling

Question 67

how is MCD diagnosed on rads?

Answer 67

rad signs of DJD, severe cartilage damage may be present

Question 68

most definitive tool for dx MCD

Answer 68

arthroscopy, enables direct visualization and assessment of cartilage surface

Question 69

arthroscopic techniques to tx MCD arthritic lesions

Answer 69

microfracture and abrasion arthroplasty create channels for revascularization, may aid in recruiting stem cells, limited benefit

Question 70

what are other surgical tx of MCD

Answer 70

decreasing transarticular loads via segmental ulnar osteotomy