01/16/2025
Hip Dysplasia
Hip dysplasia is a hereditary condition resulting in malformation of the hip joint. The hip joint is a “ball and socket” joint; in dogs with hip dysplasia, the acetabulum (socket) is typically too shallow to accommodate the femoral head (ball) and the femoral head is malformed. Poor congruity of the femoral head and acetabulum result in joint laxity, wear on articular cartilage, and eventual osteoarthritis.
Symptoms
Large breeds are affected more commonly than small breeds. Early symptoms of hip dysplasia can include a “bunny hopping” rear limb gait, rear limb lameness, narrow rear limb stance, difficulty going up stairs, laxity in the hip joints, and reduced hip and thigh muscle mass. Over time with the development of progressive osteoarthritis, the disease can be quite debilitating resulting in severe lameness and difficulty rising, rear limb weakness, marked thigh muscle atrophy, pain and reduced mobility.
Diagnosis
Diagnosis of hip dysplasia involves a comprehensive history, physical examination with gait assessment, palpation of hips for laxity under sedation, and performing radiographs of the hips while the pet is sedated, using either the OFA (Orthopedic Foundation of America) or Penn Hip methods. Because hip dysplasia is a hereditary condition, breeds with increased risk should have hip certification prior to breeding. Dogs which have confirmed hip dysplasia should not be bred.
Treatment & Management
Treatment options for hip dysplasia include medical or surgical management. The choice of treatment will depend on age at onset of symptoms, the severity of symptoms and response to medical management.
Medical management options include joint supplements, and pain medications including NSAID (non-steroidal anti-inflammatory drugs), Tramadol, and Gabapentin; weight management, physical therapy and laser therapy.
For symptomatic puppies diagnosed at a very young age (less than 4 months), Juvenile P***c Symphysiodesis (JPS) is a feasible treatment option. For these patients, Penn Hip studies are recommended for initial diagnosis. The JPS procedure involves cauterizing the area where the left and right halves of the p***s join. This affects the growth of the entire pelvis, resulting in better congruity of the hip joint.
For symptomatic dogs less than one year of age, triple pelvic osteotomy (TPO) is another surgical option. TPO surgery involves cutting three pelvic bones (ileum, ischium, p***s) in order to rotate the hip socket to provide better coverage of the femoral head. After performing the cuts (osteotomies) a bone plate is used to secure the new position of the pelvic bones. For most dogs, one hip is operated rather than both at the same time, allowing for adequate recovery time (2 months) between procedures.
For older dogs with pain and reduced mobility, either FHO (Femoral Head Ostectomy) or THR (total hip replacement) surgery are options to consider if medical management fails. FHO involves removal of the femoral head (ball component of the ball and socket joint); a “false joint” is formed during the healing phase and early return to function and physiotherapy is important for these patients. FHO is not recommended for dogs over 50 lbs. Total hip replacement is preferred for larger dogs. THR surgery is similar to hip replacement for humans; a prosthetic implant is placed in the hip socket and femur, forming a synthetic hip joint. Patients undergoing THR may return to full function very quickly after surgery. In summary, hip dysplasia is a hereditary condition that can be debilitating but can be managed with medical or surgical options to improve the quality of life of your pet.