Hip Procedures


Hip Dysplasia 

Typical HD in adult dogCT showing HD in Right hip & 2ndry OA

What is hip dysplasia?

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.

What are the signs of hip dysplasia?

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.

How is hip dysplasia diagnosed?

The diagnosis of the condition is typically based on a combination of the history, clinical signs, physical examination findings, X-rays and/or CT.







  - Non-surgical procedures

dog benefitting from our hydro service

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.



  - Double or triple pelvic osteotomy

Double pelvic osteotomy

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).






  - Juvenile pubic symphysiodesis

This is a relatively new technique for prophylactic use in immature dogs considered at risk of developing hip dysplasia  (Patricelli, Dueland et al. 2002). The basic concepts of JPS are that normal pelvic growth is concentric with the acetabuli in the dorsal half of the pelvis and the pubis ventrally. (Dueland, Adams et al. 2010). Juvenile pubic symphysiodesis involves stopping pubic (ventral pelvic) growth. This in turn results in a bilateral ventro-lateral rotation of the acetabuli (bilaterally) and an improvement in hip conformation. This results in covering the femoral head with the acetabulum.


  - Femoral head and neck excision

Femoral head and neck excision FHNE is a salvage procedure performed in some dogs that are not suitable candidates for a total hip replacement (THR). The outcome is not as good as after a successful THR.


  - Total hip replacement

cemented stem & cementless cup (1)cemented stem & cementless cup (2)

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.






  - Micro hip replacement

Total Hip Replacement is a well established procedure in large breed dogs and has been performed worldwide since the late 1970's. The surgery affords dramatically improved quality of life to patients suffering from crippling orthopaedic diseases such as hip dysplasia and avascular necrosis of the femoral head. Until recently, this surgery has not been available cats. At LVS we have recently invested in the Micro THR system, allowing us to offer this procedure to cats. Please contact our orthopaedic Specialists if you have a potential candidate you would like to discuss with them.
implant used

Micro THR versus FHNE

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.


Hip Luxation

pre-op dog with hip luxationPost-op toggle placed

Radiographs of a dog with a left sided hip dislocation before and after surgery.

The hip has been stabilised with a Toggle














Hip Fractures

pre-op hip fracturepost-op fracture repair

Here at Langford we have the expertise and equipment necessary to deal with these conditions and many more.