Top Questions about Hip Replacement Options for Family Pets
1. What is hip dysplasia, and how do I know if my pet has it?
Hip dysplasia is a hereditary condition where the hip joint develops looseness or laxity after birth. This laxity causes damage to the cartilage surface of the joint, which results in abnormal wearing and changes in the bones of the hip. The shape and fit of the bones and the joint change as osteoarthritis develops over time. These changes result in pain and loss of joint and limb function.
The signs of hip dysplasia can be seen from a few months of age and often become more obvious with growth.
Such signs may include:
- A โbunny-hopโ gait
- Stiffness or limping during or after exercise
- Reluctance to jump, climb stairs, or get in and out of the car
- Less active, reluctant to exercise, or gives up on activity quickly
- Weight shift to forelimbs (noticed by large forelimb muscles and thin hind limb muscles)
- Pain in the hip area. May lick or chew, vocalize if touched, resent people or other animals getting near hind limbs
While a physical exam by your primary care veterinarian may indicate hip dysplasia, X-rays of your petโs hips are necessary to provide a formal diagnosis. X-ray imaging also helps determine the extent and severity of the condition, which guides treatment.
2. Are certain breeds more likely to get hip dysplasia?
Yes. In dogs, hip dysplasia is especially common in larger breeds. German Shepherds, Golden and Labrador Retrievers, Bernese Mountain Dogs, St. Bernards, Newfoundlands, Rottweilers, and Great Danes are commonly affected. Still, it can also occur in smaller breeds, including Pugs and French Bulldogs, as well as hybrid breeds such as doodles. In cats, the incidence runs as high as 20% in purebred cats, particularly the Maine Coon, Persian, and Himalayan breeds.
3. What are the nonsurgical (conservative) and surgical options for treating hip issues?
If hip issues arenโt severe, the nonsurgical options for treating them include:
- Weight optimization to decrease stress on joints and lessen the inflammation associated with excess body fat
- Medications, including NSAIDs, to reduce pain and inflammation
- Modifying exercise to maintain activity and movement but not cause severe pain
- Joint supplements and injections to help slow the progression of osteoarthritis and improve joint lubrication
- Rehabilitation therapy to improve joint movement and flexibility, and limb function
- Acupuncture may be helpful for decreasing pain
If your pet is a candidate for surgery, below are three common treatments that may be offered:
- Double or triple pelvic osteotomy (DPO/TPO): In this procedure, the surgeon cuts the pelvic bone in two (DPO) or three (TPO) places and rotates the hip socket section to cover the top of the femur better. This decreases the joint laxity (looseness). These procedures are performed only in young dogs, usually less than 9โ10 months of age, and in dogs with no evidence of hip arthritis.
- Femoral head ostectomy (FHO): The idea behind this procedure is to remove bone-to-bone contact across the hip joint in hopes of decreasing pain. The top portion of the femur (femoral head) is removed. The ball-and- socket hip joint becomes a muscular joint. The FHO is referred to as a salvage procedure, reserved for when other treatments or surgical options arenโt possible.
- Total hip replacement (THR): THR is considered the most effective surgical treatment for hip dysplasia, osteoarthritis, and other conditions that affect the hip joint. Specially designed implants replace the damaged or arthritic joint, enabling your pet to return to a pain-free and active lifestyle.
A comparison chart of these treatment options can also be found here.
4. What is total hip replacement (THR) surgery? Is it safe?
For over three decades, total hip replacement has been the gold standard treatment for pets with severe hip dysplasia and/or osteoarthritis, especially when conservative measures like medication or rehabilitation therapy are no longer working. A THR involves replacing the hip socket (acetabulum) and the ball (head) of the femur with prosthetic implants. These implants are made from specific metals, polyethylene plastic, and ceramics, each of which has been uniquely designed for cats and dogs. More than 85,000 joint replacement procedures have been performed on pets since 1989.
When performed by a skilled THR surgeon, a THR procedure can have a 90โ95% success rate for good to very good hip function for the rest of your petโs life. X-rays to assess the hip implants as your pet ages will likely be recommended to monitor the implants for wear and changes. This information reveals whether the implants are functioning properly, and can guide potential implant redesigns to benefit other pets in the future.
5. How do I know if a total hip replacement is the best solution for my pet?
While medication, physical therapy, or FHO surgery can provide some pain relief for a pet with hip dysplasia or osteoarthritis, these treatments donโt prevent these conditions from worsening. Furthermore, these treatments do not provide a functional recoveryโenabling your pet to play and move freely. In practical terms, total hip replacement is the best solution to restore your petโs full mobility and quality of life.
6. How long is the recovery period, and what type of results should I expect?
Your pet will typically be hospitalized for 1โ3 days after THR surgery. Pets often can begin putting weight on their new hip on the day of surgery and can use their leg quite well within a couple of weeks โ but just as with humans, a slow and gradual return to activity is key to the long-term success of the procedure.
Your pet will be on restricted activities (leash walks only, house confinement to a small, safe space when unsupervised, and separation from other housemates) for about 6โ8 weeks after surgery. A gradual return to activities as healing progresses will be allowed after eight weeks. Most pets are ready to resume regular exercise and activities after 12 weeks of recovery. Pain medications and antibiotics are typically provided for 1โ2 weeks following surgery. In most cases, the replaced hip will last for your petโs lifetime. In fact, studies show more than 90% of dogs have good to excellent function with THR โ providing years of pain-free activity that otherwise wouldnโt have been possible.
7. How much does THR cost?
THR is an investment in your petโs quality of life. The cost of a THR procedure depends upon many factors: geographic location, implant configuration used, specific hospital surgical practices, plus additional costs related to diagnostic workup, rehabilitation therapy, dispensed medications, etc. It is one of the most advanced orthopedic procedures performed in veterinary surgery and typically costs around $6,000โ$10,000 per hip. Keep in mind that alternative treatment options, such as life-long pain management, can also result in significant expenses over the years for the check-ups necessary to monitor side effects.
Insurance is often a great option to help with costs. Much like your own health insurance, for a low monthly fee, a pet insurance policy may help cover some of the costs of your petโs healthcare. With pet insurance, vet bills are paid out of pocket upfront, then submitted for reimbursement; many companies offer up to 90% reimbursement. The cost of one major incident in the life of your pet would likely pay for a lifetime of pet insurance premiums.
It is definitely worth researching what types of procedures are covered, reimbursement rates, wellness care, and possible discounts for multiple pets.
8. How do I find a qualified, board-certified veterinary surgeon to perform THR?
If your veterinarian has suggested your dog or cat might benefit from a total hip replacement, or if you wish to seek a second opinion to further understand your petโs options, consider the following:
- Find a Movora-recommended veterinary surgeon. These professionals have advanced, specialized orthopedic training and will determine the most appropriate type of procedure for your petโs condition.
- Inquire about the surgeonโs level of expertise for the procedure being recommended. The most skilled THR surgeons perform the procedure regularly, which has been proven to improve successful patient outcomes. The more hip replacements a specialist has performed, the better served your pet will be. Not all surgeons have experience with THR.