SA Stifle and Juvenile Diseases Exam 3

What is the meniscus?

-fibrocartilage between femoral condyles and tibial plateau

-mostly type 1 collagen

-stabilization

-load bearing

-shock absorption

-joint lubricant

-mechanoreceptor

Where does the CrCL insert?

tibia

What are the functions of the cruciate ligaments?

-prevent hyperextension

-prevent excessive internal rotation

-stabilization

CrCL injuries are primarily traumatic or biological?

biological

T or F: degenerative CrCL tears are commonly bilateral

True

What are the risk factors for degenerative CrCL?

-labs, goldens, rottweilers

-female

-neutered

-large breeds

-obesity

-anatomical disposition

-endocrinopathies

Are meniscus injuries typically lateral or medial?

medial

Are CdCL tear always degenerate or traumatic?

traumatic

T or F: CdCL injuries are commonly isolated

False

How does a CrCL injury present?

-non-weight bearing lameness

-quadricep atrophy

-medial buttress

-reluctant to flex or extend stifle

-short stride

-seated with painful leg extended laterally

-CREPI

-positive cranial drawer and tibial thrust

T or F: a 3 legged lame dog has a CrCl until proven otherwise

True

What are the radiographic signs of a CrCL tear?

-marginal osteophytes

-secondary OA

What is the presentation of a CdCL injury?

-pelvic limb lameness

-pain on palpation

-joint laxity can be difficult to determine if cranial or caudal

-tibial sag appearance

What are the surgical options for a CrCL repair?

-TPLO

-TTA

-lateral suture (extrascapular)

What is a TTA?

-tibial tuberosity is osteotomized and advanced forward

-provides dynamic stabilization

-less evidence for efficacy

-stable during weight bearing

-cranial drawer may be present when non-weight bearing

What is a TPLO?

-tibial thrust is neutralized by rotating the tibial plateau to be level

-provides dynamic stabilization

-CCL becomes not necessary for stifle stabilization

-best evidence for efficacy

What is a lateral fabellotibial suture?

-replaces damaged CCL with lateral suture

-provides static and dynamic stabilization

-recent evidence is less supportive of efficacy

What is the first step to treating a CdCL injury?

repair concurrent injuries

How to treat a midsubstance CdCL tear?

conservative management

What is the function of the patella?

-increasing leverage that quadricep tendon exerts on the femur

-provides dynamic and passive stability

What kind of breeds are predisposed to patellar luxation?

small

Is medial or lateral patellar luxation more common?

medial

What kind of patellar luxation is more common in large dogs?

lateral

What are the clinical signs of patellar luxation?

-intermittent to continuous lameness

-may stretch leg backwards

-reluctance to jump

-bow legged if medial luxation

-knock kneed if lateral

-lateral is more common to cause lameness

How to diagnose patellar luxation?

-attempt to luxate patella by pushing the patella medially and laterally while internally and externally rotating the leg

-radiographs

Traits of grade 1 patellar luxation

-often an incidental finding

-patella in groove but can be luxated

-clinical signs uncommon

-minimal to no bony abnormalities

Traits of grade 2 patellar luxation

-patella in grove but can be luxated

-clinical signs are intermittent

-skipping

-lifting leg

-mild bony abnormalities

Traits of grade 3 patellar luxation

-patella out of grove but can be reduced

-crouched gait

-more consistent lameness

-moderate bony abnormalities

Traits of grade 4 patellar luxation

-patella out of groove and can't be reduced

-clinical signs present

-bow legged

-severe bony abnormalities

What patellar luxation surgical procedure deepen the groove?

-trochlear wedge recession

-trochlear block recession

-trochlear sulcoplasty

Which groove deepening procedure removes hyaline cartilage?

trochlear sulcoplasty

What are the soft tissue surgical procedures for patellar luxation?

-fascial release

-fascial imbrication

What stitch is used for a fascial imbrication?

modified mayo mattress

Which side should be imbricated for a medial patellar luxation?

lateral imbrication

What surgery results in quadricep realignment?

tibial tuberosity transposition

What is a common supplemental procedure for patellar luxations?

anti-rotational suture

What is the post operative care for patellar luxation?

-soft padded bandage

-activity restriction

-ROM physical therapy

Collateral ligament injuries are always due to wha?

trauma

What are the signs of collateral ligament injuries?

-non-weight bearing

-pain on palpation

How to diagnose collateral ligament injuries?

-radiographs

-valgus and varus stress test

How to repair collateral ligament injuries?

-imbrication if stretched

-reattachment of fragment in avulsion fx

-repair with prosthetic reinforcement if ruptured

How to surgically repair stifle OCD?

-provide site with fibrocartilage through lesion debridement

-provide site with hyaline cartilage through transplant

What is the treatment for severe stifle disease?

-total knee replacement

-arthrodesis

What is the etiology of angular limb deformity?

-trauma

-developmental

-abnormal bone synostosis

-chondrodystrophic breeds

How to diagnose angular limb deformity?

-visual exam

-lameness

-pain

-radiograph

What is a common cause of angular limb deformity?

distal ulnar growth plate injury

How to treat distal ulnar growth plate injury?

-immature use ostectomy or osteotomy

-definitive correction with plates and screws

What is the suspected etiology of avascular necrosis of femoral head?

non-inflammatory ischemia and necrosis

What kind of dog is predisposed to avascular necrosis of femoral head?

-young

-small breeds

What is the clinical presentation of avascular necrosis of femoral head?

-non-weight bearing

-unilateral

-no trauma

-pain on hip extension

-crepitus

-muscle atrophy

What are the radiographic signs of avascular necrosis of femoral head?

-osteolysis

-malformed femoral head

-possible femoral neck fracture

What is the treatment for avascular necrosis of the femoral head?

-conservative management

-FHO

-THR

-excellent prognosis

What are the predispositions to per varus?

-young dachshunds

-suspected autosomal recessive gene cause

What are the clinical signs of pes varus?

-unllateral or bilateral

-medial bowing of distal tibia

-deviation of feet toward midline

-+/- lameness

What are the radiographic signs of pes varus?

-shortening of medial tibia

-medial bowing

-+/- degenerative changes

What is the treatment for pes varus?

-surgical medial opening wedge osteotomy

-ESF

-bone plate

-excellent prognosis

What is the etiology of craniomandibular osteopathy?

-non-neoplastic proliferative bone disease of the head

-autosomal recessive

-west highland, scottish, and cairn terrier

What is the clinical presentation of CMO?

-difficulty eating

-facial swelling

-drooling

-jaw pain

Where is CMO common?

-mandible

-temporal and occipital bone

-tympanic bullae

-potentially long bones

What is the treatment for CMO?

-self-limiting

-analgesia

-hand or tube feeding

What is the etiology of retained cartilaginous core?

-failure of growth plate to ossify

-likely vascular etiology

-young large/giant breeds

What is the clinical presentation of RCC?

-lameness

-angular limb deformity

-distal ulnar physis

-commonly no clinical impact

What is the radiographic presentation of RCC?

radiolucent triangle from physis

What are the predisposing factors to hypertrophic osteodystrophy?

-large giant breed dogs

-more commonly males

What is the clinical presentation of HOD?

-intermittent shifting lameness

-swelling or pain of metaphyseal region of long bnoes

-one or multiple limbs

-systemic illness

What is the radiographic presentation of HOD?

-radiolucent metaphyseal line

-double physeal line

-metaphyseal enlargement

What is the treatment for HOD?

-self limiting

-rest

-anti-inflammatories

-hospitalization in severe systemic cases

What is panosteitis?

-inflammatory disease of bone marrow in long bones

-vascular proliferation and congestion

-bone formation around nutrient foramen

What dogs are predisposed to panoseitis?

-young large giant breeds

-males

What appears on radiographs with panosteitis?

-increased medullary cavity opacity

-loss of trabecular pattent

-periosteal bone formation

-doesn't necessarily correlate with lameness

What is the treatment for panosteitis?

-self limiting

-rest

-NSAIDs

T or F: panosteitis can occur in different bones of the same limb

True

What are the traits of slipped capital femoral epiphysis is cats?

-slow, progressive displacement of femoral epiphysis through growth plate

-often bilateral

-non-traumatic

T or F: Slipped capital femoral epiphysis in dogs is traumatic

True

What are the predisposing factors for slipped capital femoral epipysis in cats?

-siamese

-under the age of 2

-neutered males

-overweight

What are the clinical signs of slipped capital femoral epiphysis in cats?

-pelvic limb lameness

-reluctance to jump

-decreased activity

How to repair slipped capital femoral epiphysis in cats?

-FHO/FHNE

-THR

-excellent prognosis

What are the traits of swimmer syndrome?

-neonatal cats and dogs

-decreased muscle tone

-confinement and poor traction may contribute

How to treat swimmers syndrome?

-should be started within 3-4 weeks of birth

-hobbles

-rehab

-can result in euthanasia if treatment does not occur early enough

What is ectrodactyly?

-congenital digital cleft formation extending between metacarpal bones

-UNILATERAL THORACIC LIMB

What are the predisposing factors for ectrodactyly?

-autosomal dominant gene in cats

-unknown in dogs

What is the treatment for ectrodactyly?

-splint until 4-6 months to prevent muscle constricture

-conservative management

-surgical correction

-amputation