Surgery

Total Hip Replacement Surgery

Canine THR is a surgical procedure in which the coxofemoral joint or hip joint is replaced with a new prosthetic ball (femoral head) and socket (acetabulum).

The Total Hip Replacement requires special training to be performed reliably. Certification Workshops provide surgeons with the resources to ensure full recovery. Our surgeons here have taken this course and have been trained to preform THR surgery.

During surgery, the arthritic femoral head is removed, the arthritic acetabulum (cup of pelvis) is prepared, and the acetabular component (socket) is implanted.

Next, the femur is prepared, and the femoral component (stem) is implanted. The femoral head (ball) is placed on the femoral stem, and the new joint is articulated by placing the femoral head (ball) within the acetabulum (socket).

The goal of the surgery is to improve quality of life by providing pain relief and allowing the pet to return to an active lifestyle. It is the same as the operation performed in humans. The components are either cemented into the bone or cementless (press fit). Your surgeon will determine which implant best suits your pet. The cementless system relies on bone ingrowth into the implant for permanent fixation. In contrast, the cemented total hip replacement (THR) relies on bone on-growth onto the cement to provide fixation of the implant.

It is the only treatment that fully restores life-long mobility and prevents recurrence of hip dysplasia; the leading cause of hind-leg lameness in dogs. Recipients of Total Hip Replacement should be able to use the new hip for the rest of their lives. Patients are expected to recover full mobility, and suffer no lameness or muscle atrophy, overcompensation, or limitations of any kind.

 

Hip Dysplasia

Hip dysplasia is a common developmental disorder of the hip joint that affects almost all breeds of dogs. Over time, dogs with hip dysplasia often develop secondary osteoarthritis. Symptoms associated with hip dysplasia range from none to severe pain and lameness of one or both hind legs and may occur during puppyhood or later in life.

Dogs suspected of having hip dysplasia are diagnosed as having the condition based on palpation of the hip joints during a physical examination and with radiographs. Treatment for the condition often depends on the severity of the clinical signs and may involve medical management (weight control, exercise moderation, anti-inflammatory/pain medications and/or joint supplementation, stem cell therapy, platelet rich plasma therapy) or various surgical interventions (Triple Pelvic Osteotomy (TPO), Femoral Head and Neck Ostectomy (FHO), Juvenile Pubic Symphysiodesis (JPS), Total Hip Replacement (THR).

Both hips are usually affected but symptoms may be more severe on one side. Commonly presented with larger breed, Hip dysplasia is manifested by varying degrees of laxity (looseness) of the hip joint with instability and malformation of the joint components. Arthritis is the long-term consequence of hip joint laxity.

Symptoms of hip dysplasia may be subtle. They can include the presence of lameness in one or both hind legs and the reluctance to climb stairs or jump. Dogs that are affected often become less active and less playful. They may be reluctant to go on walks and their gait may be a "bunny hop" at certain speeds.

Once hip dysplasia is diagnosed, the treatment consists of either medical (conservative) or surgical management.

Medical management includes weight reduction, pain management, neutraceuticals/joint supplements (e.g. glucosamine and chondroitin), and physical therapy. Medical management has some long-term disadvantages. First, it can be costly over the lifetime of the pet; second, it does not consistently remove pain associated with arthritis; and finally, it does not give the pet a biomechanically normal hip allowing full athletic activity (unlike a total hip replacement).

Surgical management includes Total hip replacement (THR) which is the only option that will restore the biomechanics of the hip joint to normal with pain-free function. THR is one of the most successful operations used in people and animals. A femoral head ostectomy (FHO) is an old procedure where the femoral head is removed, creating a false hip joint (pseudoarthrosis). Although FHO alleviates pain, it is has been shown scientifically to not restore the biomechanics of the normal hip joint. FHO generally has a three-month recovery. Alternatively, a triple pelvic ostectomy is an operation used to treat very young dogs with hip dysplasia only selected dogs are able to have this operation.