Hip Dysplasia in Dogs - Page 6

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Hip Dysplasia in Dogs

By: Dr. Nicholas Trout

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Surgical Management

  • TPO. In young dogs, the surgery of choice is a triple pelvic osteotomy (TPO). Candidates for this surgery must have little to no evidence of arthritis on a hip x-ray and a positive Ortolani test that suggests adequate depth to the abnormal hip socket. The surgery aims to cut the pelvic bones in three places in order to free up the socket and allow its position to be altered so that the ball fits better. The new socket position is secured using a special plate and screws. By correcting the dysplastic hip early in the dog's life, further arthritic change is minimized and this should be the only surgical procedure necessary. TPO is often performed on both sides, if appropriate.

  • Some young dogs may have too shallow a socket for a TPO, but are too young and not arthritic enough for a total hip replacement (THR). Such dogs may be candidates for a "Darthroplasty" surgery in which a shelf of bone is created over the rim of the socket. This bone fuses in its new position and in doing so, stops the ball from sliding in and out of the shallow socket. This is a relatively new surgery, but in carefully selected cases has produced good results.

  • Femoral head and neck ostectomy (FHO) is a salvage surgery. Pain is produced by the grinding of the flattened and eroded ball in the arthritic and thickened bony socket. This pain can be alleviated by removing the ball thereby removing the painful bone on bone contact. Despite sounding like a strange concept, a false joint can form that is smooth and allows for walking, running and playing. This new false joint is, however, not a normal joint. There is decreased hip extension; the gait is different but the joint is pain free. The quality of the result tends to improve in smaller breeds. In heavier dogs this surgery may be acceptable where THR is not affordable.

  • THR is the ultimate salvage surgery for an arthritic dysplastic hip. If the hip joint is the rate-limiting factor behind poor use of the hind leg then replacement with an artificial ball and socket will offer the best possibility for return to function. The standard hip replacement is ideally performed in mature dogs, preferably not less than two years of age, with strong mature bone to hold the implants and a lower chance to need the hip revised during the dog's natural life span.

    When considering surgery, the biggest concern is infection and special precautions are taken before, during and after the procedure to minimize this risk. Your dog will usually require full blood work, chest x-rays and urine analysis prior to surgery. Usually the hip replaced on one side only, mainly for financial reasons. This becomes the dominant side.

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