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VMS4001 SEM 2 > Surgical management of developmental joint dx > Flashcards

Surgical management of developmental joint dx Flashcards

(41 cards)

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1
Q

Describe Capital physeal dysplasia?

A
  • Physical separation without or with minimal trauma
  • Signalment: young mature, cats > dogs, overweight, MC
  • Unknown cause - early neutering?
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2
Q

Capital physeal dysplasia on histo?

A

wide physis – irregular clusters of chondrocytes in an abundant extracellular matrix and necrotic cartilage

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3
Q

Diagnostic for capital physeal dysplasia?

A
  • VD pelvis Xray
  • Frog leg view
  • Apple core/ neck narrowing
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4
Q

Tx for capital physeal dysplasia?

A
  • Repair -> screws & K wires
    -> Also salvage procedures (THR)
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5
Q

What is Legg-Calve-Perthes?

A

-> Avascular necrosis of the femoral head (local ischaemia -> deformation)
-> Four stages: necrosis - fragmentation - reossification -healing
- Uknown cause

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6
Q

Signalment of Legg-Calve Perthes?

A
  • Small & toy breeds - terriers & poodles
  • 4-11 months old
  • Bilat
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7
Q

What signs of Legg-Calve Perthes?

A
  • Lameness - mild to NWB
  • Hip exam: pain / crepitus
  • Pelvic limb muscle atrophy
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8
Q

Diagnostics for Legg-Calve-Perthes?

A
  • sig, history, exam, radiographs/ CT
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9
Q

TX for Legg-Calve-PErthes?

A
  • Conservative
  • FHNE
  • THR
  • Novel therapies * Bone marrow –
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10
Q

What is Osteochondrosis?

A

Disorder of Endochondral ossification

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11
Q

What is the anatomy of the growth plate?

A
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12
Q

Describe Articular cartilage in osteochondrosis

A

Thin outer layer → articular cartilage

Thick outer layer → similar to growth plate → epiphyseal enlargement
Vasculature: From perichondral plexus through cartilage canals

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13
Q

Pathogenesis of Osteochondrosis?

A
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14
Q

Grading of Osteochondrosis?

A
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15
Q

What are the most common locations of osteochondrosis in dogs?

A
  • Humeral head
  • Medial aspect of the humeral condyle
  • Lateral or medial femoral condyle
  • Medial or lateral trochlear ridge of the talus
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16
Q

What is the cycle of osteochondrosis?

A
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17
Q

OSteochondrosis signalment?

Study These Flashcards
A
  • LArge breed dogs
  • 4-9 months old
  • Lameness, exercise intolerance, joint effusion, joint pain
  • Can be bilat
18
Q

Tx goals - osteochondrosis?

Study These Flashcards
A
  • ↓pain and lameness
  • restoration joint surface
  • Normalisation joint biomechanics
  • Prevention further joint degeneration
19
Q

What non surgical tx?

Study These Flashcards
A
  • Non-steroidal anti-inflammatories
  • Exercise restriction/modification
  • Dietary supplements (eg. Omega-3 fatty acids)
  • Weight control
20
Q

What are indications for non-surgical tx of osteochondrosis?

Study These Flashcards
A
  • Young dogs (<6.5mo) mildly or asymptomatic, no joint mice or in
    an area of little importance
  • Older dogs with advanced secondary OA
21
Q

Surgical tx for osteochondrosis?

Study These Flashcards
A

Arthrotomy vs arthroscopy
Flap excision + lesion periphery cartilage excision
Techniques: palliative, reparative or restorative

22
Q

Palliative vs reparative techniques?

Study These Flashcards
A

Palliative techniques → Debridement & lavage
Reparative techniques → vascular access
curettage, osteostixis, microfracture

23
Q

restorative techniques?

Study These Flashcards
A
  • Fragment re-attachment
  • Osteochondral transplants (OATS)
  • Synthetic osteochondral resurfacing (SynACart)
24
Q

what different abn in elbow dysplasia

Study These Flashcards
A
  • Fragmented medial coronoid process (>96%)
  • Humeral trochlea osteochondrosis (2.7-25.4%)
  • Ununited anconeal process
  • Articular cartilage damage
  • Joint incongruity (6-50.3%)
25
signalment for elbow dysplasia?
* Large and Giant breeds * Bernese Mountain Dog, Golden Retrievers * Young * Smaller chondrodystrophic
26
Ununited anconeal process
* Large and Giant breeds * Bilateral 20-35% * Male>Female * 5-12mo * Associated MCP fragmentation & joint incongruence * Secondary centre ossification – closing at 16-20w
27
What will we see on PE with UAP?
* Gradual onset & chronic lameness * Marked joint effusion – caudal joint * Pain – palpation & extension * Limited elbow extension
28
UAP tx options?
* AP removal * AP reattachment * Ulnar osteotomy * AP reattachment + Ulnar osteotomy
29
what does Medial Compartement involve?
* Medial coronoid process disease * Joint incongruence * Osteochondritis dissecans
30
Signalment for medial compartement dx?
Young (6-18mo) Large and giant breeds Chondrodystrophic breeds→ joint incongruence Males>Females Bilateral 25-80%
31
Medial coronoid process fissure / fragment - describe
- Genetic - Overloading -> joint instability -> humeroulnar conflcit -> joint incongruence (Radioulnar, Humeroradial, Humeroulcer)
32
tx for medial compartement dx
-Arthroscopy/arthrotomy -Biceps ulnar release procedure -Osteotomy of ulna or radius -Load changing osteotomies * PAUL * SHO -Partial elbow replacement -Arthrodesis -Conservative
33
Hip dysplasia PATHOGENESIS
34
WHAT ARE THE TWO MAIN FORMS OF HIP DYSPLASIA?
Juvenile (5-12mo) joint laxity MAture (adults) progressive degen changes
35
Describe juvenile form ?
* Sudden onset lameness * Bunny-hopping * Difficulty rising after rest * Reluctance to walk, run, jump, or climb stairs * Exercise intolerance * Pain
36
Describe mature form?
* Chronic progressive lameness * stiffness * Difficulty rising after rest * Reluctance to walk, run, jump, or climb stairs * Pain
37
Gait of hip dysplasia?
* Bunny hopping - young * Hip or spinal sway * Stiff and short-strided * Shift weight to thoracic limbs → extension tarsus/stifles
38
Muscle mass shiting in hip dysplasia?
* ↑ Thoracic limbs * ↓Pelvic limbs
39
Exam for hip dysplasia?
* Pain, crepitus, ↓ROM * Ortolani test * Barlow * Bardens
40
Tx for hip dysplasia
- Juvenile Pubic Symphysiodesis - Pelvic osteotomy - Total hip arthoplasty - Femoral head and neck excision - Conservative
41
What does conservative tx involve?
* Weight management * Modified exercise – on lead, not rough, short and frequent walks * Physiotherapy, hydrotherapy * Joint supplements

VMS4001 SEM 2 (28 decks)

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