Hip dysplasia is a common developmental abnormality that affects many breeds of dogs including Retrievers, Labradors, Collies, Mastiff and German Shepherds. It often affects both hips, although one side is usually more clinically affected than the other. Hip dysplasia is also less commonly observed in small breeds and cats.
The clinical signs of hip dysplasia, lameness and pain, can be evident as early as four to six months of age. The signs can initially be subtle such as stiffness in the morning, slowness to get up, not wanting to exercise as long or as vigorously, a change in stride of the hind legs, "bunny hopping", wanting to sit down while eating or during walks and reluctance to stand up on the hind legs. Sometimes the only observation is an "inactive" or "laid back" puppy. In some dogs the signs may not be present until it is middle-aged or older.
The diagnosis of the condition is typically based on a combination of the history, clinical signs, physical examination findings, X-rays and/or CT.
This is often initially used for the management of puppies with signs of hip dysplasia. Non-surgical management is usually made up of a combination of Exercise modification, body-weight management, physiotherapy, hydrotherapy and medication.
Most dogs will improve with conservative treatment however in some cases, as the condition progresses improvements may not be maintained. Depending on the study, between 30 -70% of puppies with hip dysplasia will respond to this management regime and not need hip surgery when they are adult.
Triple or double pelvic osteotomy is performed in young dogs (usually 6-12 months of age) that do not have any arthritic changes may be candidates for a reconstructive procedure to save the hip. This procedure is called a triple pelvic osteotomy (TPO).
Total hip replacement is frequently used for successful treatment of hip joint disease and pain caused by hip dysplasia or another condition. This procedure is well established in veterinary orthopaedics and can restore dogs and cats to normal daily activity with pain free function.
There are several variations regarding the exact technique and implants used. Typically methods involve replacement of the acetabulum (socket) with a plastic cup and replacement of the femoral head (ball) with a cobalt chrome ball on a titanium stem.
Traditionally the technique has been performed in large and medium sized dogs however recently size has not become a limiting factor. We can now perform total hip replacements in cats and small dogs.
The overall complication rate after performing a total hip replacement is reported to be between 4 and 12%. One of the most commonly reported complications is dislocation of the hip.
At Langford we use both the Biomedtrix cementless and cemented implants, tailoring the treatment to each individual patient. The system has been used in over 37,000 clinical cases.
The following study using owner questionnaire and gait analysis in 132 dogs and 51 cats receiving FHNE revealed that whilst 92% of owners thought their pets function was good with a FHNE, only 38% of dogs and cats actually had good function on quantitative assessment of gait via kinetic and kinematic analysis. The authors make the recommendation that joint replacement should be considered the 1st line treatment with FHNE reserved for a salvage surgery where joint replacement is not an option or has failed as the primary treatment modality.
Vet Comp Orthop Traumatol. 2010;23(5):297-305.Excision arthroplasty of the hip joint in dogs and cats. Clinical, radiographic, and gait analysis findings from the Department of Surgery, Veterinary Faculty of the Ludwig-Maximilians-University of Munich, Germany.1997.
Radiographs of a dog with a left sided hip dislocation before and after surgery.
The hip has been stabilised with a Toggle
Here at Langford we have the expertise and equipment necessary to deal with these conditions and many more.