Diseases of the Hip Joint
The most common conditions affecting the
hip joint of dogs and cats are hip dysplasia, hip dislocation and hip fractures.
In general, hip disease results in hindlimb weakness or lameness. Surgical
and non-surgical treatments exist for each of these conditions. Hip problems
must be distinguished from disorders of the spine and knees which can cause
The hip (coxofemoral joint) is basically
composed of the pelvis, the pelvic socket (acetabulum) and the ball (head)
and neck of the femur (thigh bone). The fibrous joint capsule, groups of
muscles, tendons and ligaments keep the femoral head in the acetabulum.
Hip Dysplasia is a congenital condition
of dogs and cats which results in laxity (looseness) of the hip joint.
This condition typically occurs in both hips and leads to deformation of
the pelvic socket and femoral head (osteoarthritis). In certain instances,
osteoarthritis leads to hip pain and hindlimb lameness. Hip Dysplasia can
be diagnosed by X-rays as early as four months of age with a PennHip®
evaluation and at 2 years of age with an OFA evaluation. Fortunately, 85%
of dogs with symptoms of hip dysplasia can be treated medically. However,
15% require surgical treatment to alleviate the pain and lameness. Some
surgeons advocate procedures which are performed during puppyhood - prior
to the onset of symptoms (such as lameness) – in an effort to avoid symptoms
which may or may not develop later in life. Many surgeons only recommend
surgery when symptomatic pets fail to respond to medical treatment.
Hip Luxation (Dislocation) is usually
the result of trauma, such as a high fall or being struck by an automobile.
Occasionally, it results from severe hip dysplasia. In many instances,
the hip can be returned to the socket under anesthesia and a sling utilized
to keep it in place while healing occurs. If the hip cannot be returned
to the socket, or if it dislocates again when the sling is removed, surgery
Hip Fractures are also the result
of trauma. They can involve the pelvis, acetabulum, femoral head, femoral
neck, or a combination of these structures. Many fractures of the pelvis
can heal with strict cage rest. However, some fractures of the pelvis,
most fractures of the acetabulum, and almost all fractures of the femoral
head and neck require surgery for appropriate healing.
is a poorly understood congenital disease of small breed dogs which results
in breakdown of the femoral neck. Fracture of the neck typically follows,
resulting in severe hip pain and lameness. Many dogs require surgery for
Surgery of the Hip
Surgery for hip dysplasia can either be
preventative or therapeutic:
Preventative procedures are performed
early in a pets’ life, prior to the onset of symptoms of osteoarthritis.
Examples include Triple Pelvic Osteotomy (TPO) and Juvenile Pubic
Symphysiodesis (JPS). I do not advocate or perform these procedures.
Therapeutic procedures are performed
when symptoms of osteoarthritis no longer respond to medical treatment.
Total Hip Replacement (THR) and Femoral Head Ostectomy (FHO)
are performed in this instance. A comparison of the therapeutic procedures
||Femoral Head Ostectomy
||Total Hip Replacement
||Removal of the femoral head and neck creating
a “false joint” from the remaining muscle, ligaments and joint capsule.
||Replacement of the femoral head and neck
and acetabulum with synthetic components creating a new, artificial joint.
||Rigorous exercise is necessary shortly
after the procedure to ensure a successful outcome.
||Exercise is restricted for 6-8 weeks following
the procedure to prevent dislocation.
||90% of pets have near to normal function.
10% have an abnormal gait or decreased flexibility – but remain non-painful
and very functional.
||95% of pets return to normal and have
excellent function.5% develop complications and require additional surgery.
Abnormal gait, decreased flexibility and poor function often result.
||Most surgeons, including myself, have
the facilities, equipment and training to perform this procedure.
||THR requires specialized equipment, training
and facilities to be performed. I refer pets to an appropriate facility
When manual replacement and slinging fail,
hip luxation is treated with Femoral Head Ostectomy (FHO), Total Hip Replacement
(THR) and several methods of joint reconstruction. I recommend and perform
FHO and refer pets to appropriate facilities for THR and joint reconstruction
Hip Fractures can be surgically
treated with pins, wire, screws and plates. The method of repair chosen
depends on the location and severity of the fracture, the size of the pet
and the presence of other orthopedic injuries.
is usually treated with Femoral Head Ostectomy because the pets
affected are typically too small for Total Hip Replacement.
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