Total hip replacement (THR) surgery is primarily performed in medium, large and giant dogs and is a major procedure with possible complications.
Candidates for THR surgery are dogs with persistently painful hips that are not responding satisfactorily to medical management, including exercise restriction, weight control and judicious use of pain killers. Signs of hip pain include difficulty rising and jumping, stiffness, lameness, restlessness, and reluctance to exercise and play. The most common cause of hip joint pain is osteoarthritis associated with hip dysplasia. This can affect dogs as young as six months of age.
Dogs with hip dysplasia / osteoarthritis, no matter how severe, are not considered candidates for THR surgery if signs of pain and lameness are mild and readily controlled by conservative measures.
Where possible the dog should be at least 10 months of age (skeletally mature) at the time of surgery. There is no upper age limit.
Cemented and cementless THRs are available. With the cemented system the artificial cup and ball are held in the pelvis and thigh bone by bone cement. With the cementless system the prostheses are secured in the bones by what is referred to as a ‘press-fit’ so that the bone in contact with the prostheses can grow into the small pores on their surface.
Joint replacements are amongst the most challenging operations performed by veterinary orthopaedic surgeons. The operation is performed through a relatively small incision directly over the hip. Careful preparation of the hip socket and top of the thigh bone is necessary prior to placement of the relevant cemented or cementless prostheses. The two artificial components are then brought together and the stability of the hip checked.
Occasionally a sling is applied to the limb for one or two weeks to prevent weight-bearing until the sutured tissues have time to heal.
Aftercare following THR surgery is very important with rehabilitation taking many months.
Exercise must be very restricted for the first few weeks until the joint capsule and other soft tissues heal. This is the period when dislocation of the prostheses is most likely. Exercise is primarily for toileting purposes. At other times, confinement to a pen or a small room in the house is necessary with avoidance of jumping and climbing.
After a few weeks, exercise may be gradually increased in a controlled manner (still on a lead) as guided by a physiotherapist and Hydrotherapy is typically recommended.
Clinical and radiographic examination is recommended one year following THR surgery and annually thereafter.
Rehabilitation is a process which aims to maximise patient mobility and wellbeing, returning them to their usual way of life following illness, injury or surgery. We restore pets to normal function (or as close as is possible), efficiently and safely using a wide variety of physiotherapeutic techniques.
Injury and even surgery can disrupt the body’s equilibrium in all sorts of direct and indirect ways. Even a pet’s own protective responses such as the inflammatory process can overwhelm and inhibit healing so one objective of rehabilitation is to reduce this level of inflammation. During rehabilitation, we also aim to boost the circulatory system, improve muscle function, increase range of motion within joints, and stimulate innate pain-relieving mechanisms.
With a committed and planned rehabilitation programme, pets can recover more quickly, realise better outcomes and avoid much pain and discomfort.
The best rehabilitation programmes consider the whole pet, not just the area of injury; we target and improve multiple systems throughout the body without forgetting the invaluable healing effects of boosting mental wellbeing too. From the wound healing properties of laser treatment, and the muscle strengthening of hydrotherapy, to the circulation boosting effects of massage, we will devise a rehabilitation programme to match a pet’s specific requirements.
The content on this page is for advice and information only and does not represent veterinary guidance or direction. Please always consult a veterinary surgeon if you are worries about your dog.