This is a list and brief explanation of the surgical options for Hip Dysplasia.


TRIPLE PELVIC OSTEOTOMY

General Info -The Triple Pelvic Osteotomy (TPO) is a surgery that preserves the natural hip joint and eliminates the looseness and prevents the progression of arthritis. For this surgery, the surgeons cut the hip in 3 places and rotate the pelvis so that the rim of the hip - acetabulum - covers the socket more. A plate is inserted to hold the hip together while the bones fuse and heal.

Recovery - All doctors seem to have slightly different recovery times, but a general rule is 8-12 weeks. Your dog will need to be confined and kept quiet during that time. The dog needs to be quiet so the bones can heal properly.

Price - It varies but ranges from - per hip.

TOTAL HIP REPLACEMENT (THR)

General Info -In this surgery, the surgeon removes the ball of the joint and reams out the femur. The surgeon fills the femur with cement and inserts a metal implant with a metal ball. The surgeon reams out the rim area and installs a plastic cup. The metal ball fits into the plastic cup, and the hip is held together with muscles.

Recovery - Similar to the TPO above. The dog needs to be quiet so the hip doesn't dislocate during recovery.

Price - Ranges, but is slighty more expensive than a TPO. Ranges from to per hip.

Most vets do a THR with cement - the femoral implant and the acetabular cup is affixed to the bone with cement. A newer method is a "cementless implant" where the implant is attached with a screw and over time, the bone forms around the implant. Check out these links to read more about the cementless implant:

http://www.vmth.ucdavis.edu/vmth/clientinfo/info/thrfaq.shtml

http://www.biomedtrix.com/faq.html#cvccthr

FEMORAL HEAD OSTECTOMY, FEMORAL HEAD AND NECK EXCISION (FHO/FHNE)

General Info - With this surgery, the surgeon removes the ball of the femur, and adds a cushion of tissue between the femur and the rim. The muscles and tissue form a false joint in the hip area.

Recovery - The recovery is very different for this surgery than for the THR or TPO. For the first week or so the dog should be quiet while the incision heals. After that, the more exercise the better, it helps to give a good range of motion to the hip while healing. Swimming is especially good exercise.

DARTHROPLASTY (DAR)/SHELF ARTHROPLASTY

DARthroplasty (dorsal acetabular rim arthroplasty) involves grafting a small piece of bone off of the side of the ileum (pelvis) to the top of the joint where the body failed to develop the proper amount of bone. This procedure works well in patients that have little to no arthritic change in the joint. It is a nice alternative to the other procedures in that it is minimally invasive in comparison and has a high degree of success.

PECTINEAL MYOTOMY

This surgery involves cutting a small muscle that puts pressure on the hip joint. It results in no loss of leg function and gives good to excellent relief in 80-90% of dogs. If both hips are abnormal, both hips may be operated on at the same time. The dog recovers from surgery in one to two days. This procedure, however, does not stabilize the hip joint or prevent progression of arthritic changes. Within a few months to several years, pain and lameness will return.

PECTINEAL MYECTOMY

This procedure is intended for the relief of acute pain in the young growing dog only. It has no effect on the development of arthritis in the hips later in life. The operation involves cutting the pectineus muscle, which runs along the inside of the thigh. This muscle's action is to pull the legs inwards (adduction). Cutting it is believed to relieve tension on the fibrous capsule which surrounds the hip joint. Pectineal myectomy is usually quite cheap because it is a relatively easy operation to do. However, it is only indicated where medication has been unsuccessful in relieving the pain of hip dysplasia in a young growing dog.

THREE PLANE INTERTROCHANTRIC OSTEOTOMY

Portions of the femoral head are cut in order to change the angle at which it fits into the acetabulum. This is an early-stage procedure which is not done after arthritis has set in. Personally, I have never heard of any dog having this surgery, but I did find some information about it on the internet. I think now that the TPO is widely used, this surgery is no longer used.

JUVENILE PUBIC SYMPHYSIDESIS(JPS)

With this surgery, the area near the center of the penvis is heated. This kills cells responsible for pelvic development. By changing these "growth plates," the bones of the pelvis are forced to grow at different rates. That makes the pelvis grow at an angle that provides a better fit for the hip. When mature, the hip socket has rotated to a more horizontal angle, thus making it less likely the ball on the end of the femur will pop out. The procedure should be performed when dogs are between 16-20 weeks of age, with best results when the dog is 16 weeks old.