FAQ - Canine Hip Replacement in the South of England

What is Hip Dysplasia?
What are the clinical signs of Hip Dysplasia?
Can you tell from my dog's x-rays (radiographs) if he/she is a good candidate for THR?
What are the treatment options for Hip Dysplasia?
What is a Canine Total Hip Replacement?
Why choose a Total Hip Replacement?
Is your dog a candidate for Total Hip Replacement?
What can I expect from this surgery?
How do dogs feel with a Total Hip Replacement?
Does a Total Hip Replacement "Wear out"?
Should both hips receive a Total Hip Replacement?
What is the surgery like from a patient's perspective?
What is the postoperative care for my dog?
What is the success rate for a Total Hip Replacement?
Are there any risks?
When should the surgery be performed?
My dog is on medication. Should I stop giving this?

What is Hip Dysplasia?

Hip Dysplasia is an abnormal development and growth of the hip joint. Both hips are usually affected, but only one hip may show symptoms. The onset of clinical signs may not occur in both hips simultaneously. Hip Dysplasia is manifested by varying degrees of laxity (looseness) of the muscles and ligaments around the hip joint with instability and malformation of the joint components. Arthritis is the long term consequence of hip joint looseness.

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What are the clinical signs of Hip Dysplasia?

The clinical signs of Hip Dysplasia are lameness and pain which can be evident as early as four to six months of age.

The symptoms can initially be as subtle as:

stiffness in the morning.
slowness in getting up.
not wanting to exercise as long or as vigorously.
a change in stride of the back legs.
"bunny hopping".
wanting to sit down during walks or while eating.
reluctance to stand up on the hind legs.

Sometimes the only observation is an "inactive" or "laid back" puppy. The symptoms may not be present until a dog is middle-aged or older. Dogs showing signs of discomfort can be any age and of any size. However, large breed dogs are more commonly affected.

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Can you tell from my dog's x-rays (radiographs) if he/she is a good candidate for THR?

Radiographs show abnormalities in the hip joint and are used for choosing the proper sized prosthesis but they are only part of the picture. To decide what is best for your pet, the surgeon must evaluate your pet’s history, perform a complete physical examination, evaluate your pet’s radiographs and interpret laboratory data. Many factors must be evaluated before your pet is considered a good total hip candidate.

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What are the treatment options for Hip Dysplasia?

Several treatment options are available to address Hip Dysplasia. Young dogs (usually 6-12 months of age) that are dysplastic and do not have any arthritic changes present are candidates for a reconstructive procedure to save the hip. The procedure is called Triple Pelvic Osteotomy (TPO). Ask for more information if your puppy falls into this category. A total hip replacement (THR) is a treatment option if the components of the hip joint are worn or deformed from the ravage of arthritis and/or treatment of pain is unsuccessful. Salvage procedures, such as removal of the femoral head (FHO - Femoral Head Osteotomy), provides a "scar tissue" joint which provides limited stabilty and range of motion. A total hip replacement can provide more normal stability and range of motion.

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What is a Canine Total Hip Replacement?

A canine THR is a prosthetic hip that is implanted in a similar fashion as is done in humans. It essentially replaces the arthritic joint. The prosthetic hip replacement has three components:

The femoral stem.
The femoral head.
The acetabular cup.

The implants are available in six sizes and are interchangeable to accurately fit the individual patient and provide proper joint tensioning. The components are made of cobalt chrome and ultra high molecular weight polyethylene.

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Why choose a Total Hip Replacement?

THR's are performed to relieve pain, improve hip function, and allow your dog to return to an active life style. The arthritic joint is replaced with the implant to eliminate the pain resulting from bone rubbing on bone in the arthritic joint. The reduced motion of the arthritic joint is also corrected allowing your pet to regain a full range of motion of that limb.

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Is your dog a candidate for a Total Hip Replacement?

If your dog has Hip Dysplasia, is over 9 months of age (with growth plates fully developed) and weighs more than 30 pounds, you have a likely candidate for a THR. A thorough examination to rule out other problems is a mandatory part of the preoperative examination. Dogs that have had femoral head excision (FHO - Femoral Head Osteotomy) are usually not good candidates.

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What can I expect from this surgery?

The goal of surgery is to return your pet to pain-free, mechanically sound, normal hip function. Generally, dogs are found to be more comfortable and have an improved quality of life. Many owners report that their pet can do things they have not done since they were a puppy. Increase in muscle mass, improved hip motion, and increased activity levels have been observed in most patients. Working dogs have returned to full activity. Some mean dogs have even developed a pleasant personality when the pain was eliminated from their hips.

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How do dogs feel with a Total Hip Replacement?

Most dogs walk on their new hip immediately after surgery. Most pet owners report that their dog's personality improves because their hip pain is eliminated. Gradual return to their normal function takes place between 8 and 12 weeks after surgery. A long term study found THR to be a very effective method of treating disabling conditions of the canine hip. The majority of these dogs displayed marked improvement in walking, sitting, climbing stairs, standing, running, getting into cars, playing and exercising following surgery. THR's have been successful in both pets and working dogs.

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Does a Total Hip Replacement "Wear out"?

The life of a THR in humans can be over 20 years. Replacement of implants due to wear and tear has not been necessary in dogs partially because dogs weigh less than humans, their weight is distributed on four rather than two legs, and their average life span is considerably shorter.

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Should both hips receive a Total Hip Replacement?

Only one hip should be replaced at a time. However, if debilitating pain is present in both hips, then both hips should be replaced. The most painful hip should be replaced first and an interval of at least 2 months should elapse prior to performing the second hip surgery. Dogs with both painful hips benefit greatly if both hips are replaced.

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What is the surgery like from a patient's perspective?

The surgery takes 90 to 120 minutes. The patient is placed under general anesthesia and vital signs such as heart rate, heart rhythm, tissue perfusion, respiratory rate, blood pressure and temperature are monitored.

The surgery is performed with extensive attention paid to sterile techniques. A great deal of attention is paid to preoperative preparation of the patient, instrument preparation, aseptic technique, and environment control in the operating room. The hair on the patient's leg is clipped and the skin is bathed a few days prior to surgery to ensure that the skin shows no sign of infection.

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What is the postoperative care for my dog?

The postoperative care for your dog is critical. The surgical incision must be monitored daily for redness, swelling or discharge. Your dog must be discouraged from licking the incision. This sometimes requires placement of a special collar to prevent your pet from reaching the incision. Your dog’s attitude and appetite should be monitored daily while the incision heals. Ten to fourteen days after surgery the sutures may be removed from the incision.

The activity level of your pet must be strictly controlled. For the first month after surgery your dog should be allowed outside, on a leash, to urinate and defecate and for a short walk. Your pet should be immediately returned to the house afterwards. Inside the house your pet should avoid stairs and slippery floors. If your pet must go up and down some stairs, you should go with the pet using a leash or your hand on the collar to control the speed of your pet on the stairs. Good footing is important. Absolutely no running, jumping or playing is allowed in the first 2 months after surgery. When your dog is not under your direct control, he/she should be kept confined to a small room. Some owners find that a large cage or airline crate is an ideal place to confine their pet when they are not at home.

For the second post-operative month, similar restrictions apply but you may begin to take your pet on longer leash walks. The length of the walk will depend on your dog’s abilities. After the end of the second month, you may return your pet to full activity.

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What is the success rate for a Total Hip Replacement?

Total hip replacements have been successfully performed in canine patients since 1974 and have enjoyed excellent results. Over 95% of patients return to normal function after the surgery. Most dogs will run, jump, play normally, and have an improved quality of life.

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Are there any risks?

The incidence of complications is very low. Risks exist just as they would for any surgery. Infection, implant loosening, technical problems, and anesthesia complications can never be totally eliminated, however, extreme precautions are taken to minimize these problems.

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When should the surgery be performed?

Surgery is recommend when pain or lameness is present. The hip will be painful when extended and/or abducted. Radiographs of the hips are used to confirm the diagnosis of degenerative arthritis. A conservative approach using pain relievers may be initially recommended. Surgery is recommended if medication is needed over an extended period of time or if ineffective.

Long delays in performing surgery can lead to longer rehabilitation time. THR is ideally performed before the hind leg muscle begins to loose its mass (atrophy). Additionally, a delay means less time for your dog to enjoy the improved pain-free function provided by the total hip replacement.

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My dog is on medication. Should I stop giving this?

Medications for health problems / conditions such as diabetes or low thyroid function should not be stopped. Medications for hip pain should be stopped prior to the initial examination. Oral steroids (even for skin conditions) should be stopped 1 week before the exam while other anti-inflammatory drugs including aspirin should be stopped 3 days before the exam.

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