Jeff D. Brourman DVM, MS, DACVS, Board Certified Veterinary Surgeon
WestVet Animal Emergency and Specialty Center, Boise, Idaho Chicago Veterinary Emergency and Specialty Center, Chicago, Illinois
Total hip replacement veterinary surgery help dogs suffering from hip dysplasia return to an active, more pain-free life.
Hip dysplasia is a hereditary disease that affects many dogs. Certain breeds such as German Shepherds, Mastiffs, Labrador, and Golden Retrievers are more often afflicted with the disease, though it can occur in any pure or mixed-breed dog. Efforts have been made to reduce the number of affected dogs using selective breeding, however, hip dysplasia can still develop with no reports of prior hip disease.
How hip dysplasia occurs in dogs.
The hip joint is a ball-and-socket joint made up of ligaments, tendons, and bones. Normally, the head of the femur (the ball) is deeply seated into the acetabulum of the pelvis (socket). Dogs born with hip dysplasia undergo a complex process affecting both the bones and the soft-tissue structures of the hip. Throughout the first year of life, these changes result in laxity or a “loose” joint. This looseness further results in subluxation (partial dislocation) of the hip. Frequently, this may be accompanied by a “popping” of the hip which may be heard or felt. In severe cases, the hip may completely dislocate with minimal pressure or no trauma. The laxity of the hip joint frequently results in inflammation, pain, changes to the soft tissue and bone structures, and ultimately, osteoarthritis which can progress throughout a dog’s life. Typically most dogs are at least a couple years of age before radiographic evidence of arthritis is present; though it is not uncommon for dogs as young as 8 months of age to have arthritic changes visible on x-rays.
Signs of hip dysplasia in dogs. Many dogs affected with hip dysplasia may not show abnormal signs. Some will show signs of pain, including difficulty rising, trouble with stairs, “bunny-hopping” while running, a reluctance to stand or jump using the hind limbs, and a gait which can best be described as a “waddle”. Dogs with severe hip dysplasia may be quite debilitated, sometimes even before any radiographic evidence of osteoarthritis is apparent. Veterinarians use a combination of signs, symptoms, and physical examination to diagnose hip dysplasia. The disease is confirmed by x-rays of the pelvis.
Treatment for Hip Dysplasia in dogs.
Treatment for a dog suffering from hip dysplasia greatly depends on the signs the animal exhibits. Many dogs with hip dysplasia and secondary osteoarthritis may show little to no clinical signs of the disease and can lead normal lives without medical or surgical intervention. Some dogs having problems may respond well to conservative treatment, which usually consists of anti-inflammatory medication, chondroprotective agents such as glucosamine, physical therapy, and weight loss. Others either do not respond to medical treatment or respond initially, but then require frequent dosing in order to stay comfortable. These dogs are considered candidates for surgical intervention.
Surgical Procedures for Hip Dysplasia.
A variety of surgical procedures have been used in veterinary medicine to treat hip dysplasia. Those most commonly performed today, however, are femoral head ostectomy (FHO), triple pelvic osteotomy, and total hip replacement.
Total hip replacement is considered the gold standard for surgical treatment of hip disease in dogs and in people. The procedure involves removing the femoral head (ball) and a portion of the acetabulum (socket) of the hip joint and replacing them with a prosthetic ball and socket, similar to what is done in people. The implants are either held in place with bone cement (cemented system) or without bone cement (cementless system). These days, the cementless system is more commonly used and preferred by most surgeons.
The procedure maintains a high rate of success. Most dogs have a significant improvement in quality of life. Dogs that have had a total hip replacement compensate well by shifting their weight to the operated limb. Because of this, 80% of dogs receiving a total hip replacement do not need to have a total hip replacement performed in the opposite hip, even if it has significant arthritic changes.
The recovery time for total hip replacement is generally 8 to 12 weeks. Restricted activity during this time is important to assure proper healing. Complications of the procedure are rare but can include dislocation, sciatic nerve injury, bone fracture, implant loosening, or infection requiring implant removal and/or revision. Most dogs experience a significant improvement in pain relief and function following total hip replacement. After the recovery period most dogs are able to resume a normal quality of life including running, jumping, playing, or hunting.
Hip dysplasia is a common disease among dogs. If you think that your pet may have the signs of hip dysplasia, have him or her evaluated by your family veterinarian. Your veterinarian will attempt to diagnose the problem and guide you through appropriate treatment options.