Hip dysplasia

What is hip dysplasia?
Hip dysplasia is a multifactorial developmental disorder of the hip joint resulting in a reduced stability of the joint and thus causing degenerative changes.
Hip dysplasia is the most common orthopedic condition in large breed dogs, but each breed can be affected.
Diagnosis is made based on the orthopedic examination combined with radiography.
Several treatment options are available for hip dysplasia. Treatment-decision is made based on the age, the weight, the amount of arthrosis and the function of the dog.
Conservative treatment
A conservative treatment consisting of e.g. controlled exercises, weight control, anti-inflammatory drugs and physiotherapy can be applied in dogs with mild symptoms and in young dogs with minimal radiographic changes. In case the result is insufficient surgery can be considered.
Triple pelvic osteotomy
In a triple pelvic osteotomy (TPO) the acetabulum is tilted to better encompass the femoral head. The aim of this technique is to correct the subluxation of the femoral head so the degenerative changes do not increase any more. This technique can only be applied in dogs < 10 months old with minimal arthrosis.
Femoral head and neck excision
In this technique the head and neck of the femur is removed so a pseudo-joint can be created. The advantage of this technique is the fact that it can be performed in every phase of the condition. A femoral head and neck excision is most successful in small and medium size dogs, but can also be performed in large breed dogs.
Palliative procedures
Palliative procedures are undertaken when joint disease is sufficiently severe that addressing the suspected underlying pathology is likely to be insufficient, or when more conservative treatment has failed. In these cases an arthrodesis or an amputation can be considered.
When an arthrodesis is performed the normal function of the joint is destroyed. In these cases all cartilage is removed from the joint and the bones are fixed with a plate and screws. In time bone healing occurs and the leg can be used again.
Although the limb can be used in a pain free way, this type of surgery usually results in a substantial functional lameness. An arthrodesis is mostly successful in the carpal and tarsal joint. In other joints prognosis after this procedure is less predictable.
In some cases the limb cannot be saved e.g. complicated fractures or a tumor. In these cases an amputation can be advised. This procedures has a large impact on the animals mobility. However, most animals adapt quickly. In general the amputation of a hind limb has less consequences then the amputation of a front leg. In case the animal was already not using the limb anymore, it will adapt even faster to the new situation. Also physiotherapy might help the dog/cat to adapt faster.