Hip replacement in dogs is not new. It was first carried out over fifty years ago. Over the years the procedure has developed considerably, and it can now be performed even in very small dogs. The most common reason for a dog to undergo hip replacement surgery is to treat hip dysplasia. It is also used in some cases to treat fractures or dislocations of the hip. Surgery is both a costly and a complicated procedure and should only be performed by surgeons with significant experience. If hip replacement is recommended for your dog, how do you know whether it is the right decision?
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Hip dysplasia
Hip dysplasia is the most common reason for a dog to be considered for hip replacement. But what is hip dysplasia? The hip joint is a ‘ball and socket’ joint. In dogs with hip dysplasia, the joint does not develop correctly, and the ball and socket do not fit together quite as they should. This leads to instability and discomfort. As dogs get older, osteoarthritis may develop as a result of this ongoing instability. Some breeds such as Labradors, German Shepherd Dogs and Golden Retrievers are more prone to developing hip dysplasia, but it is possible in any dog. Signs are often first seen at about 6 months of age although problems may not be obvious until significant secondary osteoarthritis develops some years later.
How can you tell whether your dog is struggling with hip pain?
This can be difficult as signs can be subtle. You may notice that your dog is not as enthusiastic on their walks. They may be reluctant to jump, and they may be slow to get up from resting. If this is the case, then it is best to get your dog checked out by your vet. Many dogs with hip dysplasia can be managed without the need for surgery. Signs may be mild, and in these dogs, pain relief, weight control and physiotherapy may help. For some dogs however, these treatments will not significantly improve clinical signs. It is these dogs who are generally considered for hip replacement surgery.
What does surgery involve?
Hip replacement surgery entails the replacement of the entire hip joint with an artificial joint (prosthesis). The top of the thigh bone (femur), which forms the ‘ball’ of the hip joint, is removed and replaced with a metal ball. A plastic cup replaces the acetabulum or ‘socket’. These artificial components can be held in position using cement or in some cases can be cementless (sometimes called ‘press fit’).
Dogs may require surgery on one or both hips. Hip replacement is rarely performed on both sides at the same time as this increases the risk of complications. However, even where there are problems with both hips, replacement performed on one side only can often significantly improve clinical signs (Anderson, 2011).
Following surgery, a period of restricted activity is required to allow healing of soft tissues. Recovery times of 6-12 weeks would be considered normal. Further x-rays are usually required to check the new hip. It is important that post operative instructions from your vet are strictly followed to reduce the risk of complications.
When can surgery be performed?
In most cases surgery is not performed in dogs under 9-10 months of age. Before this time your dog will still be growing at a significant rate. Almost all dogs will be older than this when they have surgery and there is no upper age limit.
What outcome can be expected?
In 90-98% of dogs the outcome following hip replacement can be expected to be good or excellent. Long term, most dogs have either no lameness at all or only mild intermittent lameness (Anderson, 2011). It is hoped that in the majority of cases, surgery will significantly reduce or eliminate hip pain, allowing dogs to be more active and improving their quality of life.
Are there any risks?
Complications can occur with any surgery and hip replacement is unfortunately no exception to this. It is important that before your dog undergoes the procedure that you fully understand the risks. Complications are reported in 5-10% of cases (Foster et al 2012, Henderson et al 2017). Whilst this might seem relatively low, some of these complications can be potentially serious. The most common complication is dislocation (luxation) of the artificial hip joint. Less common complications include fracture of the femur, loosening of the implants and infection. Further surgery is often required to deal with more serious complications.
What will it cost?
The cost of surgery will depend on many factors, including the size of your dog and what initial tests have already been performed. Surgery is very likely to cost in excess of £5000. If both hips require surgery, then the cost will be doubled. If complications arise then there can be significant further expense associated with these.
Overview
Hip replacement surgery is a complicated procedure that does carry risks. It is important to have a clear understanding of these risks before deciding to go ahead. Surgery is reserved for those dogs with significant disease associated with one or both of their hip joints. In these cases, hip replacement surgery can offer a considerable improvement in quality of life.
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References
- Anderson A (2011) Treatment of Hip Dysplasia Journal of Small Animal Practice Vol 52 Page 182-189
- Henderson E et al (2017) Evaluation of variables influencing success and complication rates in canine total hip replacement: results from the British Veterinary Orthopaedic Association Canine Hip Registry (collation of data: 2010-2012) The Veterinary Record Vol 181(1) Page 18
- Forster E (2012) Complications and Owner Assessment of Canine Total Hip Replacement: A Multicenter Internet Based Survey Veterinary Surgery Vol 41(5) Page 545-550
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