Total Hip Replacement Procedure for Pets
Veterinary orthopedic medicine made significant advances in recent years. Total hip replacement for dogs and cats is no longer considered an extreme and rare solution for certain hip joint disorders. In fact, it’s a standard option to treat the end stages of hip dysplasia, or even early intervention for younger patients. It’s the only solution that has the best potential to provide a return to normal hip function and eliminate joint pain. The surgeons at the Bone and Joint Center have extensive experience performing total hip replacement procedures in patients of various sizes.
Hip Dysplasia and Osteoarthritis
Hip dysplasia is a developmental disorder in which the hip joint is abnormally shaped. The hip joint consists of the ball and the socket, which normally grow at the same rate. In cases of hip dysplasia, this growth is not uniform and leads to laxity of the joint and ultimately osteoarthritis. Because of the altered biomechanics of the hip joint, osteoarthritis develops early and can cause significant pain and discomfort.
Signs of hip dysplasia vary. Some pets exhibit severe lameness, while others show only mild discomfort. You might notice weakness in the rear legs, trouble getting up from lying down, and difficulty or reluctance using stairs. A physical exam along with an X-ray and, in some cases, a CT scan will be able to determine if your pet suffers from hip dysplasia and its severity.
Total Hip Replacement Surgery
Total hip replacement surgery removes and replaces both the ball (femoral head) and the socket (acetabulum) with prostheses. Most hip replacement prostheses have a metal ball at the top of the femur that fits into a dense plastic socket. These components are fixated in place with bone cement or “press fit” (bone ingrowth) methods.
Advantages of a Total Hip Replacement:
- It closely mimics the mechanics of a normal hip joint
- It offers the best chance to restore full hip functionality
- It provides the best option for pain-free joint
- It eliminates or reduces the need for pain medication
- It has a high success rate
- It can be performed on dogs of various sizes, as well as cats
- It offers quick recovery time (pets can use the hip the day of surgery, and full recovery takes 12 weeks)
Total Hip Replacement FAQs
A total hip replacement is recommended when the hip joint is damaged beyond repair. Hip dysplasia and severe osteoarthritis is the main condition where total hip replacement is recommended. But it can also be suggested in cases of traumatic or chronic luxation of the joint, failed femoral head and neck ostectomy (FHO), and irreparable acetabular or femoral head fractures. Our surgeons will thoroughly evaluate your pet’s condition and determine if a total joint replacement is the best option.
With the introduction of micro and nano joint replacement options, we can now perform hip replacement surgery on patients of different sizes.
After a total hip replacement, your pet will be able to walk right away, but the activity level will need to be restricted for approximately 12 weeks. The first 6 weeks need to be stringent. There can be no running, jumping, playing, or access to stairs, and a sling should be used when walking. At-home physical therapy exercises, such as passive range of motion and weight shifting, are highly encouraged. At the 12-week mark, most pets are cleared for a progressive return to normal activity.
Yes, patients will be hospitalized overnight following a total hip replacement procedure. In some instances, two-three nights might be necessary. Our 24×7 hospital is the best place for your pet to recover after surgery under the monitoring of our staff.
The prognosis for recovery to full function is excellent after total hip replacement surgery, pending no complications.
Risks associated with a Total Hip Replacement include luxation, femoral fracture, and infection. Severe complications occur in up to 10-15% of the cases. Most complications occur during the first few weeks after surgery and can be addressed successfully. Infection can occur up to a year after surgery (and potentially even later) but is quite rare (~1-2%). Infection can have severe consequences after THR and may require removal of the prosthesis.
While bilateral hip replacement can offer the best outcome in certain cases, approximately 80% of dogs with osteoarthritis in both hips only require one total hip replacement to enjoy good comfort and function.
Medical management using NSAIDs (non-steroidal anti-inflammatory drugs) can successfully alleviate discomfort in some pets when paired with activity modulation and weight loss (if needed). NSAIDs do, however, have the potential to damage major organs, so it is important to ensure that recent bloodwork has been performed before starting new drug regimens. Prioritization of lower-impact activity (walking, swimming) and professional physical rehabilitation can also be helpful for a successful conservative approach. Conservative management does not undo the dysplasia and osteoarthritis but rather helps manage the discomfort associated with those conditions.
The femoral head and neck ostectomy (FHO) is considered a salvage procedure. It removes the ball of the ball-and-socket joint, leaving just an empty socket. With the ball removed, muscles of the leg will initially hold the femur in place. Over time, scar tissue will form between the socket and the femur to provide cushioning, which acts as a false joint. While FHO can be successful in some cases, the excellent results are much rarer than in total hip replacement. A dog’s hip joint is always severely biomechanically altered by the FHO procedure, and the dog’s leg is shortened to a variable degree. Aftercare requires a long and intense rehabilitation process. The major postoperative complications include persistence of the lameness, discomfort, and stiffness of the joint – especially when adequate physical rehabilitation is not performed following surgery.