The Surgery For Hip Dysplasia

Answers To Questions About Canine Total Hip Replacement

by Ronald K. Fallon D.V.M.

Many factors enter into the decision to have a total hip replacement performed on your pet. You may have questions about the procedure. The answers to the most commonly asked questions about total hip replacement follow. We hope you find this information helpful and would be happy to answer any other questions you might have.

What is total hip replacement (THR)?

Both the ball (head of the femur) and socket (acetabulum) of the hip joint are replaced with prosthetic implants. The new ball is made from a cobalt-chromium metal alloy and the new socket from high-density polyethylene plastic. Special bone cement is used to hold these implants in place.

How do you determine if my dog is a candidate for a THR?

A painful hip(s) that is affecting your dog’s comfort and locomotion is the primary indication for a THR. Stiffness, lameness and reluctance to exercise are often signs of problems. Your pet must be in good general health. There must be no other joint or bone problems, no nerve disease, and no other medical illnesses.

Your dog must be skeletally mature; that is, he/she must be finished growing. Generally this occurs by 9 to 12 months of age. X-rays of the hips determine this. The size of the bones must be large enough to fit the available sizes of total hip prosthesis. Again, x-rays are needed to determine this.

Total hips can generally be placed in dogs weighing 30 pounds or greater. A dog with arthritic hips that has pain-free, normal function is not a candidate for THR.

The goal of surgery is to return your pet to pain- free, mechanically sound normal hip function. Generally, dogs are found to be more comfortable and have an improved quality of life. Many owners report that their pet can do things they have not done since they were a puppy.

What can I expect from this surgery?

Increase in muscle mass, improved hip motion, and increased activity levels have been observed in most patients. Working dogs have returned to full activity. Some mean dogs have even developed a pleasant personality when the pain was eliminated from their hip(s).

Since the expertise of the surgeon(s) is very important, what experience do the surgeons at AVS/MVSS have with the procedure?

In 1976 surgeons from The Ohio State University began evaluating the effectiveness of this procedure. This evaluation continues today. Dr. Ron Fallon was first trained in Total Hip Joint Replacement while at The Ohio State University in 1984. Since the first hip was put in, over 2500 total hip replacements have been performed by surgeons from Ohio State. More canine total hips are done at Ohio State each year than in any other university or private practice in the world.

In 1994-1995 and 1998-2000 our team in Baltimore performed more total hip replacements than any other private practice in the world. Surgeons at Ohio State have been leaders in developing and writing about total hip replacement surgery. Owner and referring veterinarian cooperation on providing follow-up information has been invaluable in the effort to evaluate and continually improve this procedure.

We are pleased to have Dr. Marvin Olmstead, Professor of Small Animal Orthopedic Surgery at The Ohio State University, and a Diplomat of the American College of Veterinary Surgeons and one of the innovators of THR in the dog, as an original member of our hip replacement team since 1992.

Is surgery performed the day of admission?

No. Your pet must be carefully screened before surgery. This entails a complete history and physical examination. X-rays of the hips, taken earlier, are reevaluated. The complete blood count and chemistry profile obtained to screen your dog for evidence of infection, anemia, or problems with internal organ function is examined. Your pet’s skin is carefully examined for signs of infection and if found to be okay, a preliminary clipping is performed. Surgery is usually scheduled for the next day.

How long will my pet stay in the hospital?

The routine length of hospitalization for patients with THR is 2 Days.

What is the success rate of THR?

In reviewing the records of patients that have had THR, a little over 95% of dogs have had good to excellent function with this procedure. These patients have pain-free function, increased muscle mass, no limping, and increased activity.

What are the complications with this surgery?

As with any surgery, total hip replacements have their own set of complications. The complications include dislocations, fractures of the femur, infections, loosening of the implants, and nerve damage. Total Hip Replacement procedures are continually being evaluated and improved.

The risk of a complication occurring is low. Some complications seen in the early stages of development of the technique have been totally eliminated, while the risk for other complications has been greatly reduced. Methods of treating the few complications that so occur are also being developed and evaluated. Most complications can now be successfully resolved, preserving the hip replacement.

What is the postoperative care for my dog?

The postoperative care for your dog is critical. The surgical incision must be monitored daily for redness, swelling or discharge. Your dog must be discouraged from licking the incision. This sometimes requires placement of a special collar to prevent your pet from reaching the incision.

Your dog’s attitude and appetite should be monitored daily while the incision heals. Ten to fourteen days after surgery the staples may be removed from the incision. This may be done by your local veterinarian. Please make an appointment for the staple removal.

The activity level of your pet must be strictly controlled. For the first month after surgery your dog should only be allowed outside, on a leash, to urinate and defecate and for a short walk. Your pet should be immediately returned to the house afterwards. Inside the house your pet should avoid stairs and slippery floors. If your pet must go up and down some stairs, you should go with the pet using a leash or your hand on the collar to control the speed of your pet on the stairs. Good footing is important.

Absolutely no running, jumping or playing is allowed in the first 2 months after surgery. When your dog is not under your direct control, he/she should be kept confined to a small room. Some owners find that a large cage or airline crate is an ideal place to confine their pet when they are not at home.

For the second post-operative month, similar restrictions apply but you may begin to take your pet on longer leash walks. The length of the walk will depend on your dog’s abilities. After the end of the third month, you may return your pet to full activity.

Do I have to bring my animal back for a check up?

No. However, we would like to reevaluate all radiographs and any problems. We understand that people come to us from all over the United States, so if it is not convenient for you to return, ask that you have your veterinarian x-ray your dog at 3 months after surgery and annually thereafter.

We also ask that those x-rays and a report on your pet’s function be sent to us so that we may record that information in your pet’s medical records. We have been able to follow some dogs for more than 12 years. We will only be able to evaluate long-term results of THR if we have the cooperation of owners and referring veterinarians.

Both of my dog’s hips are affected. Will both need to be replaced? How do you decide which hip to replace?

Four out of five dogs or 80% of the patients with arthritis in both hips only require one side be operated upon to return them to a satisfactory and comfortable life. The decision on which hip to replace is based on the owner’s observations, the physical examination findings, and the hip x- rays. Your knowledge of your pet’s disability is the most one important in making this decision.

How much does the procedure cost?

In 2002, the cost was $3200-$3500. This includes the immediate presurgical examination, surgical laboratory culture, post-operative x- rays, hospitalization fees, antibiotics, anesthesia, surgical fees, and the cost of the implants and surgical sundries. We are doing everything we can go keep the costs of this procedure low, but as manufacturers increase their charges, we must raise ours.

Is THR the only treatment available for my pet?

No, besides THR, other possibilities for treatment of your pet include conservative therapy and several other surgical options. Which treatment should be used on your pet depends on many factors. The best treatment option will be discussed with you, after we have taken a history, evaluated x-rays, and completed an orthopedic examination of your pet.