Hip Dysplasia - FUSION VETERINARY ORTHOPEDICS

Hip Dysplasia

Diagnosing and treating this condition in pets.

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What is Hip Dysplasia

Hip dysplasia is a common orthopedic condition characterized by the abnormal formation of the hip's ball-and-socket joint, leading to joint inflammation and secondary osteoarthritis (OA). The condition's causes are multifactorial, involving genetics and environmental influences, with joint laxity being a central factor. In young dogs, this laxity allows the ball of the hip joint to slip partially out of the socket and then reduce catastrophically, causing inflammation, pain, and abnormal cartilage wear that results in OA.

Introduction:

Clinical signs of hip dysplasia vary with the disease stage and the dog's age. In young, skeletally immature dogs, signs are related to joint laxity and may include a "bunny hopping" gait, reduced playfulness, lameness, or stiffness after rest or heavy activity. In mature dogs, signs are associated with OA, such as slowing down during activities, reluctance to navigate stairs or furniture, limping, or stiffness after exercise. Any of these signs should prompt an orthopedic examination at Fusion Veterinary Orthopedics, involving a detailed history, gait analysis, joint palpation, hip extension measurement, and radiographs to assess hip conformation and OA severity.

Treatment for hip dysplasia is tailored to the individual patient and includes both conservative (non-surgical) and surgical options. Conservative treatment focuses on lifelong management to improve hip function, maintain muscle mass, and alleviate pain, involving daily exercise, weight control, and potentially formal rehabilitation. Surgical options vary by the dog's age and clinical signs. For very young dogs, juvenile pubic symphysiodesis (JPS) can improve hip joint coverage. For dogs aged 6-10 months without OA, a triple/double pelvic osteotomy (DPO/TPO) may be performed. Total hip replacement (THR) is considered the gold standard for dogs over six months, providing normal to near-normal function, while femoral head and neck excision (FHO) is an option for dogs not suited for THR but involves a reliance on scar tissue formation and requires rigorous rehabilitation.

How does this occur?

Mature Dogs

In dogs that are skeletally mature and have failed a true conservative approach and are not a candidate for a total hip replacement then a femoral head and neck excision (FHO or FHNE) can be completed. An FHO in the past has typically been reserved for smaller dogs and cats; however, larger dogs can also be candidates. It involves removal of the entire femoral head and neck and relies on the formation of scar tissue. Because of this reliance on the formation of scar tissue to develop appropriately formal rehabilitation therapy is REQUIRED beginning 5-7 days following surgery. While the outcome can be satisfactory the overall athletic ability of the dog is decreased and most will retain some loss of hip extension that could affect daily activities. At Fusion Veterinary Orthopedics, we recommend a THR over an FHO in most situations.

Young Dogs

In very young dogs (16 weeks or younger) juvenile pubic symphysiodesis (JPS) can be completed. This is a procedure that improves coverage of the ball into the socket as the dog continues to develop.

6 - 10 Months With No Osteoarthritis

In dogs that are 6-10 months of age with no osteoarthritis present a triple/double pelvic osteotomy (DPO or TPO) may be recommended. This is a procedure that relies on cutting portions of the bone to improve the coverage of the ball into the socket. Prior to performing a DPO or TPO hip arthroscopy (inserting a small camera into the hip) may be recommended. Given the ability to perform a total hip replacement in very young dogs; a DPO or TPO is not commonly recommended.

6+ Months

In dogs that are 6 months or older a total hip replacement (“THR”) is considered by most to be the gold standard treatment of hip dysplasia as well as some hip luxations and fractures. In the past it has been reserved for larger dogs; however, it can now be completed in smaller dogs and even cats. A THR results in normal to near normal function. In addition, we can perform THRs in younger patients that will give them a pain-free great quality of life.

What Happens After Surgery?

Postoperative care involves 8-12 weeks of rest and restricted activity, with gradual reintroduction of controlled exercise. Physical rehabilitation is recommended to begin two weeks after surgery (or 5-7 days for FHO) to aid recovery by maintaining muscle mass and range of motion. Complications from surgeries like DPO/TPO or THR can include implant breakdown, postoperative hip luxations, infection, and soft tissue injuries, with specific risks for THR including aseptic loosening, implant failure, femur fracture, hip luxation, and sciatic nerve damage. Ensuring careful postoperative care and rehabilitation can help mitigate these risks and promote a return to normal function.

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