There are conservative, or non-surgical, methods for treating hip dysplasia, such as pain medications, weight loss programs, controlled exercise, and physical therapy. These methods can be very effective in certain cases. However, conservative treatments do have their limitations.
The other option is surgery. There are two surgical approaches for dealing with hip dysplasia: prophylactic procedures, which are designed to prevent the progression of arthritis, and therapeutic procedures, which aim to treat or salvage already arthritic hips. The primary prophylactic procedure available is called a triple pelvic osteotomy. In this procedure, three separate bone cuts are made in order to free the acetabular component (the socket or cup) of the hip joint from the rest of the pelvis. The acetabulum is then rotated to provide better coverage, and a bone plate is applied to maintain this new position and allow the bone cuts to heal. This procedure is quite effective if it is performed before significant arthritis is present; after this time period, it is no longer a useful procedure. A veterinarian can assess whether the dog is a good candidate for this procedure. Another type of preventative surgery, currently under clinical investigation at several universities, is pubic symphysiodesis, a procedure for very young dogs that manipulates the way the pelvis grows to create a tighter hip. Studies are being conducted to help determine whether this procedure is safe and effective.
Aimed at treating hips that have already become arthritic, the therapeutic procedures available for dysplastic dogs include total hip replacement, femoral head ostectomy, and investigational surgeries such as the DARthroplasty. In a total hip replacement procedure, which is generally performed on a severely debilitated dog weighing more than 50 pounds, a prosthetic hip socket and a femoral head are implanted into the dog, forming an artificial "ball-in-socket" joint. This gives the dog a pain-free hip joint and nearly normal function after the recovery period. Total hip replacement is a technically demanding surgery, and usually is done by highly trained individuals at referral practices and universities. When performed by experienced surgeons, the success rate approaches 95 percent; nevertheless, complications, while uncommon, can be devastating. For this reason, this procedure is reserved for animals with the most severe signs of hip dysplasia.
Femoral head ostectomy is a surgery performed on severely arthritic dogs. With this procedure, the femoral head ("ball" part of the joint) is removed, allowing the femur to float about freely and causing scar tissue to form. As the scar tissue hardens and thickens, it serves to create a "false-joint" called a pseudoarthrosis. The femoral head ostectomy is a last resort procedure and generally is not recommended for mild cases of arthritis. This procedure is more effective in smaller, well-muscled dogs. Among dogs weighing more than 50 pounds, the results will vary.
The DARthroplasty has been employed recently to treat hip dysplasia in young dogs. With the goal of relieving pain, this new surgical technique involves transplanting bone from the pelvis to the hip socket in order to stabilize the joint. Since controlled studies are lacking, and only a limited number of surgeons can perform this procedure, the DARthroplasty should be considered investigational until more information is gathered.
With any treatment, postoperative recovery depends not only on the procedure, but also on the aftercare. The same principles of non-surgical therapy are applied following surgery: obese animals must lose weight and pain medications should be used when needed. Follow the veterinarian's recommendations closely.
