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Surgical
Treatments For Hip Dysplasia
by
Anita R. Weidinger, D.V.M.
Hip dysplasia
is an arthritic condition of the coxo-femoral joints of the dog.
This hip joint is a ball and socket joint and the dysplasia can
effect either the head of the femur (ball) or the acetabulum
(socket). Early hip dysplasia is an instability of the hip joints
and usually shows up during puppyhood by eight to nine months
of age. Effected puppies are slow to get up and down, tend to
use their back legs together as opposed to independently (referred
to as bunny hopping) and may limp on one of their rear legs.
The insta-bility of the hips makes the body try to stabilize
the joints by building extra bone (osteophytes) and causing the
joint capsule and ligaments associated with the joint to thicken.
The normal cartilage of the joints is gradually worn off and
the joint becomes painful in addition to unstable. Most dogs
are at least a few years old before the degenerative changes
of arthritis advances enough to cause problems. The dogs show
these problems by limping, difficulty getting up and down, slowing
down on walks and at play, and shying away from stairs.
Surgical
intervention is one way to treat hip dysplasia and the arthritis
that accompanies it. The three most commonly used surgeries are
triple pelvic osteotomy, femoral head and neck excision, and
total hip replacement.
The total
hip replacement (THR) is the most effective treatment in that
it gives the dog the most anatomically correct and sound hip
joint post surgically. This procedure is performed almost exclusively
at Veterinary teaching hospitals and large referral practices.
This surgery requires a great deal of special equipment and a
well trained surgical team to obtain the best results possible.
The THR is also the most expensive surgical option at about $1,750.00
per hip. The good news is that most dogs only need one hip done,
as this procedure gives them one good leg to stand on and takes
the pressure off the other rear leg.
The triple
pelvic osteotomy (TPO) is only performed on young dogs usually
less than eighteen months of age. This procedure involves cutting
the pelvis in three places and rotating the socket to improve
how well the femoral head and acetabulum fit together. The pelvis
is then fixed into its new position with orthopedic plates and
screws. This surgery can not be done after there are arthritic
changes in the joint because the arthritis will most likely progress
even after the surgery. More Veterinarians are trained for this
procedure but it does require plating equipment and runs about
$800.00 per hip. Unfortunately, performing this procedure on
a young dog with unstable hips does not guarantee that degenerative
changes will not still develop in the hip joints.
The third
surgical option for hip dysplasia is a salvage procedure known
as the femoral head and neck excision or ostectomy (FHO). Referred
to as a salvage procedure, once this is performed, no other procedure
can be done on that same joint. This surgery involves cutting
the femoral head and neck off of the femur and removing it. This
leaves the dog with a false joint of ligaments, muscle and joint
capsule since the ball part of the joint has been removed. Most
of the time this surgery is reserved for dogs with severe arthritic
changes in their hips or for younger dogs with very unstable
or luxating hips. Usually, smaller dogs do better with an FHO
but larger dogs can also have good success with it. This surgery
is more widely available and is usually the least expensive of
the three surgeries but varies from Veterinarian to Veterinarian.
Surgery
is not required for all dogs with hip dysplasia.
The decision
for surgery and which surgery should be made on an individual
basis. The dog's clinical signs, X-rays, response to medications
and finances needs to be considered before decisions are made.
Talk to your Veterinarian about what is best for your dog and
you.
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