Legg-Calvé-Perthes Disease

This older technique was popular in the 1970s. It involves cutting the pectinious muscle of the groin to lessen the pain of dysplasia. Cutting this muscle was said to decrease the normal pressure that presses the ball of the femur into the acetabular socket. Some veterinarians thought it might be helpful in certain cases of hip dysplasia. However, the relief provided was usually temporary and arthritic changes in the joint continued or possibly sped up. Few veterinarians still perform this surgery but it is no longer recommended by most veterinarians.

Juvenile Pubic Symphysiodesis is a less extensive, less expensive attempt to improve the dog’s hip structure. When the growth in one portion of the pelvis (the pubic symphysis) is surgically halted, a change occurs in the pelvis’ shape as the rest of the structure grows. Theoretically, this should improve hip function by creating a more stable joint. However, the same report in the January 15, 2007 issue of the Journal Of The American Veterinary Medical Association questioned this. When the surgery is performed, it must be done when the pup is young (16-20 weeks of age) and after the likely hood of future hip dysplasia is confirmed by a PennHip examination.

Dorsal Acetabular Rim Augmentation techniques uses bone grafts to enlarge the lip of your dog’s hip socket (the acetabulum) that holds the ball of its femur in place. There is insufficient information on how successful this procedure might be. The positive thing that is known is that if the DARA technique is not successful, other techniques could still be tried later. In 2016, the DARA technique is most commonly used in dysplastic dogs to try to give added support to a totally prosthetic (artificial) hip.

Triple Pelvic Osteotomy procedure has been used since the early 1990s. It works best when hip dysplasia is discovered very early – before degenerative changes and arthritis become noticeable on radiographs. Dogs need to be 7 – 8 month old or older to have this surgery and it generally does not yield good results when dogs are over 12 months old. The bones that form the hip are not mature enough to hold the screws and plates that are used when the puppy is too young. And the pet will not have the full potential to remodel the new joint structure if it has finished most of its growth. So the window or time when the surgery is most effective is quite small.

It is also very difficult to perform this surgery on dogs that weigh less than 45 pounds because the surgeon must work in such a tight space.

This surgery entails cutting free the socket or acetabulum at three points (A,B&C) and rotating it so that the pressure of the femoral head is directly into the cup and not pressing on it’s upper edge. Metal plates, screws and wire are used to reattach the acetabulum to the pelvis in its new position. Recovery from the operation, which is performed only on one leg at a time, is 6-10 weeks. Surgeons that perform this operation are quite enthusiastic about the results they obtain. However, “Results suggest that JPS and TPO have similar effects on hip joint conformation in dogs with moderate to severe hip dysplasia but that neither procedure eliminates the hip joint laxity characteristic of hip dysplasia or the progression of the degenerative joint changes. If you are considering this surgery for your pet, ask the prospective surgeon to discuss these 2007 University of Wisconsin results.

During Femoral Head Osteotomy surgery, the head and neck of the femur are removed. After that is done, a flexible , fibrous attachment (pseudo-joint) naturally forms between the end of the femur and the pelvis. This should allow pain-free experience use of your pet’s leg.

The surgery is straightforward. The results are usually excellent when the dog’s adult weight is 45 pounds or less. It does not work well for heavier dogs. It can take up to a year for full motion and weight-bearing to return. But it is a real joy to see these pets racing happily and pain-free once again. When hip dysplasia affects both legs, operating on both hips simultaneously is preferred. This forces the dog to use both rear legs soon after the operation and prevents them from just carrying the repaired leg.

In hip dysplasia, it is the friction and grinding of the head of the femur against the socket of the pelvis that causes the pain. When the head of the femur is removed, the surgeon places muscular and connective tissue between the two former joint surfaces. As this consolidates with additional new scar and cartilaginous tissue, this pseudo-joint becomes pain free and allows almost natural motion. The pet will maintain the knee on that leg slightly straighter to compensate for the slight shortening of the femur.

For the first few weeks after surgery, many veterinarians confine the pet to a small cage and have the owner frequently massage the muscles of the leg. By the fourth to sixth week after surgery, your veterinarian may encourage as much light activity as possible to prevent further atrophy (withering) of the muscles of the leg. Many have the owners passively flex and extend the leg and continue massages four times a day. Dogs and cats do quite well on three legs so it is difficult to get them to start using the repaired leg. Sometimes I resort to taping a sock onto their good rear leg to encourage them to use the newly reconstructed joint. It is also proven that swimming really hastens recovery and use of the affected leg.

Within six months of surgery almost all dogs run about as if nothing had happened.

A total artificial hip replacement or prosthetic joint is also an option for your pet. It replaces the painful arthritic joint and can be performed at any stage of the disease. This process has become routine in humans but cost limits its use in dogs. It is the only technique that works in dogs over fifty pounds with advanced dysplasia. The modular prosthetic hip replacement system used today has three components, a femoral stem, a femoral head, and the artificial acetabulum. Each component has many available sizes, which allow for a custom fit. The components are made of cobalt chrome stainless steel or titanium and ultra high molecular weight polyethylene or another advanced self-lubricating plastic.

This procedure is quite expensive and only performed at large veterinary centers. It has a high success rate and changes in the dog’s mobility are nothing short of miraculous.

The surgery can be performed on dogs of any weight and at any adult age – as long as their general health is good. It’s biggest disadvantage is its cost. Hips are usually replaced one at a time. Often, one replaced hip is enough to restore the pet’s mobility.

The technique for total hip replacement in dogs was pioneered by veterinary surgeons at Ohio State University. Their orthopedic group still performs more canine hip replacements than any other university or private practice in the World.