1. “There is no need to have a Plan B because it distracts from Plan A.”
STAY FOCUSED
“There is no need to have a Plan B because it distracts from Plan A.”
-Will Smith

2. DISEASES OF THE MUSCULOSKELETAL SYSTEM
PART 3

3. POOR CONFORMATION: LUXATING PATELLA

4. POOR CONFORMATION: LUXATING PATELLA

5. POOR CONFORMATION: LUXATING PATELLA

6. POOR CONFORMATION: LUXATING PATELLA
PATELLA IN
GROOVE
PATELLA
OUT OF
GROOVE

7. TREATMENT OF PATELLAR LUXATION
TROCHLEAR WEDGE RESECTION

8. TROCHLEAR WEDGE RESECTION

9. TREATMENT OF PATELLAR LUXATION: TIBIAL CREST TRANSPOSITION

10. POOR CONFORMATION: HIP DYSPLASIA
YOUNG DOGS 5-8m AND MATURE
ANIMALS WITH CHRONIC DISEASE

11. POOR CONFORMATION: HIP YSPLASIA

12. POOR CONFORMATION: HIP DYSPLASIA
Acetabular vs. Femoral hip dysplasia
Poor conformation combined with genetic, environmental and nutritional factors

13. POOR CONFORMATION: HIP DYSPLASIA
PHYSICAL EXAM FINDINGS
Pain on palpation of hips
Joint laxity (positive ortolani sign) – subluxation of hip
Crepitus
Decreased range of motion of hip joints
Atrophy of thigh muscles
Hypertrophy of shoulder muscles

14. POOR CONFORMATION: HIP DYSPLASIA

15. Hip Dysplasia DIAGNOSTICS: Radiographic view
ventrodorsal view of the pelvis with rear limbs extended symmetrically and rotated inward to center the patellae over the trochlear grooves
For standard Orthopedic Foundation for Animals–type radiographs to evaluate hip conformation, extend the hips and internally rotate the tibias until the patella lies directly over the trochlear grooves. Be sure the pelvis is straight, with symmetric obturator foramina.

16. POOR CONFORMATION: HIP DYSPLASIA and OFA CERTIFICATION

17. POOR CONFORMATION: HIP DYSPLASIA and OFA CERTIFICATION

18. HIP DYSPLASIA and OFA CERTIFICATION
Dysplastic hips are categorized as mild, moderate, or severe

19. PennHip Evaluation
Distraction View
Compression view
Extended View

20. HIP DYSPLASIA TREATMENT: medical management
NSAIDs
NEUTRICEUTICALS/CHONDROPROTECTIVE AGENTS

21. HIP DYSPLASIA TREATMENT: MEDICAL MANAGEMENT
Polysulfated glycosaminoglycan (Adequan):
Polysulfated glycosaminoglycans prevent cartilage breakdown by inhibiting the enzymes of cartilage degradation during inflammation.
Cosequin:
Cosequin is a brand name for glucosamine HCL combined with chondroitin sulfate which may stimulate synthesis of synovial fluid, inhibit degradation, and improve healing of articular cartilage.

22. Hip Dysplasia Treatment: surgical correction
Total hip replacement
Salvage procedure in mature dogs with severed DJD unresponsive to medical Tx
Pain free and near normal limb function in 95% of cases
Femoral Head Ostectomy
Forms “false” joint
Removal of femoral head and neck to prevent joint pain
Salvage procedure when medical treatment not working and other sx too expensive
Best - < 20#; good musculature
Abnormal gait
Triple Pelvic Osteotomy
Allows rotation of dorsal acetabular rim to increase coverage of femoral head
Good return of function with minimal arthritic changes

23. HIP DYSPLASIA TREATMENT: surgical correction
TRIPLE PELVIC OSTEOTOMY

24. HIP DYSPLASIA TREATMENT: SURGICAL CORRECTION
FEMORAL HEAD OSTECTOMY
“False joint” forms from scar/fibrous tissue

25. HIP DYSPLASIA TREATMENT: SURGICAL CORRECTION
TOTAL HIP REPLACEMENT

26. Hip Dysplasia – Client Info
Weight control important to decrease load on painful joint
Swimming excellent activity
Lameness may occur due to surgical shortening of the affected limb
Physiotherapy – decreases joint stiffness, helps maintain muscle integrity
Joint degeneration progressive
May be heritable – do not breed
Special diets designed for fast growing dogs may decrease severity