Total Hip Replacement Generalities
Dogs with hip pain often exhibit only subtle symptoms – especially initially. Risks involved with the surgery exist, as they do for people getting a hip replacement, but they are not great for most dogs. A highly experienced surgical team will minimize THR complications. THR surgery is common in dogs less than 1 year of age but it can be performed at any age if there are no other health issues that take priority. Perioperative pain relief is routinely provided for every dog. The THR components are not expected to “wear out”. Rehabilitation after THR surgery is easy for most dogs. Vigorous and strenuous activity should be eliminated during the first 2 months post-operatively but “normal” daily activity around the house is acceptable. After rehabilitation, all activity can resume except the most strenuous activities. Endurance activity, such as long daily walks, is good for a dog’s general health and does not create a THR complication.
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Normal Hips at 10 months
Normal hips in a dog less than 10 months of age with open growth plates. The femoral heads are seated deep in the acetabulii with congruency of the articular surfaces.
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Hip Dysplasia in a Young Dog
Hip dysplasia in a young dog. There is subluxation of the femoral heads. Bone structure changes have not occurred yet. The laxity of the femoral heads plunging in and out of the acetabulii is palpable during examination. An Ortolani sign is present.
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Bilateral Triple Pelvic Osteotomies
Staged bilateral triple pelvic osteotomies (TPO) have been performed to correct hip dysplasia that was present. Both femoral heads are now well seated in the acetabulii similar to normal hips. The plates and screws were used to hold the reconstructed pelvis in place during healing.
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Normal Hips in an Adult Dog
Normal hips in an adult dog older than 24 months of age. The hips were graded Excellent by the Orthopedic Foundation for Animals (OFA). As in the young dog (Top picture), the femoral heads are deeply seated and are round. The femoral neck, at the base of the head, is a narrow area.
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Hip Dysplasia with Secondary Arthritits
Hip dysplasia with secondary arthritis in an adult dog. The femoral heads are no longer seated deeply in the acetabulii. The acetabulii are filling with bone – especially on the most affected side. A flattened area is present on one femoral head and the other is becoming dome shaped. The femoral necks are no longer narrow due to the presence of new bone formation. An osteophye is present on one acetabular rim. Both hips are painful when they are extended during examination.
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Chronic End Stage Degenerative Joint Disease
Chronic severe end-stage degenerative joint disease secondary to hip dysplasia. The femoral heads are malformed and articulate with shallow acetabular remnants. Large osteophyes are present on the femoral necks and acetabular rims. Thigh muscle atrophy was evident due to chronic weight redistribution to the front legs.
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Hip Luxation
A hip luxation occurred as a result of trauma in a dog with pre-existing arthritis from hip dysplasia. The opposite hip is normal. A Total Hip Replacement was performed to resolve both the luxation and the arthritis at the same time. Normal function of a pain free joint was reestablished.
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Femoral Head Osteoctomy (FHO) vs THR
A Femoral Head Ostectomy (FHO) was performed several years previously on one hip. Even after extensive rehabilitation after the FHO, this dog continued to suffer from hip pain and dysfunction. The opposite hip, which became progressively more arthritic and painful, received a Total Hip Replacement. The improvement in quality of life after the THR was dramatic even though problems continued on the FHO side.
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Bilateral THRs
Total Hip Replacements were performed 3 months apart. Both sides can be replaced when dogs suffer from pain, dysfunction, muscle atrophy, or other symptoms. There are instances when both hips are replaced at earliest convenience. In other scenarios, there is a waiting period to determine if the procedure is necessary and indicated on the second side.
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