Hips and Pelvis

 

Hip Dysplasia

 

Canine Hip Dysplasia (CHD), the most common developmental orthopedic disease in dogs, is an abnormal development and growth of the hip joint. Both hips are usually affected but frequently only one hip may show symptoms. The onset of clinical signs may also not occur in both hips simultaneously.


CHD is characterized by varying degrees of laxity (looseness) of the muscles and ligaments around the hip joint with instability and malformation of the femoral head and acetabulum. Osteoarthritis is the long term consequence of hip joint instability and incongruency. 


 

Management of Hip Dysplasia in Young Animals

 

Juvenile Pubic Symphysiodesis (JPS)

 

Juvenile pubic symphysiodesis may cause acetabular rotation that significantly improves femoral head coverage by induced and premature closure a dysplastic puppy’s pubic growth plate. JPS achieves these results by creating tension at the pubis and using the continued growth of the rest of the pelvis to achieve acetabular rotation over time. The growing cells of the pubic growth plate are destroyed during the surgical procedure. Since the rest of the pelvis continues to grow, the pubic bone acts as an anchor causing the pelvis and acetabulum to rotate outwardly and ventrally. Dysplastic puppies are reported to return to a normal gait and achieve diminished hip laxity following JPS. 

 

Studies show dramatic improvements in hip coverage and hip laxity in dysplastic puppies following JPS. Puppies had normal, pain free gaits without any complications from the pubic growth plate closure. Results indicated that the greatest benefit from JPS was achieved in puppies 3-4 months of age but significant improvement can be expected in patients up to 5 ½ months old.

 

Juvenile pubic symphysiodesis is often a prophylactic procedure since most dogs do not display clinical signs of hip dysplasia until they are older than 6 months of age. JPS should be strongly considered in puppies of proper age and within “at risk” breeds (Labrador retrievers, Rottweilers, German Shepherds, Golden retrievers, etc.) for hip dysplasia. Risk factors include puppies where one or both parents have hip dysplasia or when hip laxity is demonstrated in the puppy on physical examination or radiographs.

 

This is a very exciting technique and has been performed at ASG with results similar with those previously described. JPS is simple, effective, virtually complication-free, has minimal postoperative restrictions and is far less invasive and expensive compared to traditional surgical procedures.

 

Below are PennHIP distraction radiographic hip images of a Spinone Italiano puppy at 16 weeks of age (left) and 6 months postoperative (right) JPS.  Note the dramatic difference in hip joint laxity/distraction and congruency.

 

 

 


 

 

 

Management of Severe, Chronic, Degenerative Joint Disease due to Canine Hip Dysplasia 

 

Total Hip Replacement - Biomedtrix cementless (complete, press-fit ingrowth prosthesis), cemented and hybrid (cemented femoral stem, ingrowth acetabular cup) implant systems


Biomedtrix first introduced what is today known as the CFX™ system - a cemented hip replacement prosthesis for dogs in 1990.  In 2003, the Biomedtrix introduced the BFX™ system - a press-fit, bone ingrowth prosthesis.  Since inception, over 50,000 hip replacement procedures have been successfully performed in dogs. 


A broad range of implant sizes in both BFX and CFX components allows the surgeon to treat hip problems in a wide range of patients and disease conditions.


To learn much more about hip replacement surgery and answers to the most common questions, click on the Need to Know link at the left.

 

 

Femoral Head and Neck Excision Arthroplasty (FHO/FHNE)

 

FHO is a relatively simple technique that involves removing the ball portion of the hip so that there is no longer bone rubbing on bone in the diseased joint. While FHO can relieve much of the pain of osteoarthritis, the loss of the normal ball and socket structure of the hip usually means that the limb will not function normally. In general, small, light-weight and high energy dogs have better outcomes with FHO. The advantages of FHO include less surgical risk, shorter procedure times, few intra- and postop complications and lower costs of care.


One of the more common questions surrounding FHO is if a dog doesn’t recover well, can a THR be done after that?  An FHO can sometimes be converted into a total hip replacement, however it is a technically demanding procedure with a higher complication rate than primary total hip replacement.  The longer the interval from the FHO to a revision, the more difficult the total hip replacement becomes, with the best results occurring if the total hip replacement is performed early (4-6 weeks) after the FHO.