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Hip dysplasia

What is hip dysplasia?

Hip dysplasia (HD) is a multifactorial developmental disorder of the hip joint. This causes reduced stability and can lead to degenerative changes in the joint.

Hip dysplasia in dogs is not congenital (meaning puppies are born with normal hips), but develops at an early stage of growth. It is therefore entirely possible that a puppy appears completely healthy at the time of purchase, but begins to show signs of dysplasia after a few months. Hip dysplasia is the most common orthopaedic condition in large dog breeds, but in principle any breed can be affected.

The final diagnosis is made on the basis of orthopaedic examination combined with X-rays. There are various options for treating hip dysplasia, and the choice of treatment is determined in part by the dog's age, weight, degree of osteoarthritis and function.

Techniques

1. Conservative treatment

Conservative treatment consists of intensive physiotherapy, controlled walks on a leash, weight control and, if necessary, anti-inflammatory drugs and nutritional supplements. This treatment can be tried in dogs with mild symptoms and in young dogs with minimal radiographic features. If this does not lead to improvement, surgery may be considered.

2. Surgical treatments

2.1 Pelvic tilt

In a pelvic tilt (Triple Pelvic Osteotomy, TPO), the acetabulum is rotated around its axis so that the femoral head fits better into the acetabulum. The aim of this treatment is to correct the subluxation (poor alignment) of the femoral head so that the degenerative changes cannot progress further. This technique can only be performed on dogs with mild signs of osteoarthritis (ideally younger than 10 months, but in some cases it can also be performed on slightly older animals).

2.2 Femoral head and neck excision

This technique involves removing the femoral head and neck, after which a pseudo joint is formed. The major advantage of this technique is that it can be performed at any stage of the condition. A femoral head and neck excision is mainly successful in small and less heavy dogs, but can also be performed on larger dogs.

Because there is no longer a joint after the operation, everything must be supported by the surrounding muscles. It goes without saying that this operation must be accompanied by intensive physiotherapy to stimulate the use of the leg as quickly as possible.

2.3 Hip replacement (Total Hip Replacement, THR)

The most common reason for performing a hip replacement is to relieve the pain and discomfort caused by severe degenerative changes secondary to hip dysplasia and intra-articular bone fractures. Other causes include chronic hip dislocation and non-reducible acute hip dislocations.

During this procedure, the painful or damaged hip joint is removed and replaced with a prosthesis. This eliminates the cause of the pain and/or stiffness and allows the patient to resume normal activities.

During the operation, the femoral head is removed and replaced with a titanium “stem” to which a titanium head is also anchored. This head fits perfectly into the artificial socket that has been placed in the pelvis.

Most dogs recover quickly and can use the operated limb again after just a few days. During the first few weeks after the operation, movement will be limited to a few short walks, but walks can be increased quickly.

Clinical and radiological checks are necessary to evaluate progress and, if necessary, to intervene quickly in the event of possible complications such as infection, bone fractures and the “loosening” of the prosthesis.

The prosthesis will remain in place for life and will enable the patient to carry out normal activities without pain, which would otherwise not be possible. With improved surgical techniques and prostheses, the future looks promising.