INTRODUCTION

The hip is a "ball and socket" type of joint. In the normal dog, the head of the femur, the femoral head, (the "ball" portion) sits tightly into the acetabulum of the pelvis (the "socket" portion).

Hip dysplasia is a developmental abnormality wherein a puppy develops loose and abnormally shaped hip joints as it is growing. This is known as "incongruency" between the shape and function of the femoral head and the acetabulum. The angle of the top of the acetabulum may not be level, allowing the femoral head to slide "in and out" as the puppy is walking.

Damage to the cartilage and joint lining occurs with every step. The end result is progressive abnormal development of the acetabulum and pain!

Although hip dysplasia is inherited (passed on from the parents), overfeeding high protein/high calorie diets and over-supplementing with vitamins or minerals, especially calcium, can worsen or accelerate it's development in fast growing puppies.

TREATMENT
Hip dysplasia is a very painful condition and if identified early, surgical procedures exists to effectively treat and correct the problem. In very young patients (less than 4 months of age, fusion of the central growth plate of the pubic bones may result in improved joint development on both sides of the pelvis. This procedure is called, Juvenile Pubic Symphysiodesis (JPS).

In older puppies (5-10 months of age) Triple Pelvic Osteotomy (TPO) is recommended. The TPO procedure involves precision cuts in the three bones of the pelvis to rotate and correct the angle of the hip joint.

This rotation and realignment allows the femoral head to "seat" more deeply within the acetabulum such that the hip joint can go on to develop in a more normal fashion.

In some dogs, a short femoral neck may be contributing to the hip dysplasia. A procedure to lengthen the femoral neck may be required at the same time or within a few weeks of pelvic osteotomy. TPO is generally performed on the worst hip first, followed by surgery on the opposite hip a few weeks later. Some patients may be candidates for Bilateral Pelvic Osteotomy (BPO), wherein both sides are operated at the same time.

POST-OPERATIVE AFTER-CARE
Patients can begin to resume normal activity after 6-8 weeks of strict rest. Strict rest entails confinement to a pen or crate with leash-controlled walks to urinate and defecate when not confined.

If both hips need surgery, the second side can be operated on at about 4-6 weeks. It takes upwards from 12-16 weeks for full strength to return. Prognosis is better than 95% for good to excellent function following surgery. Factors such as the age of the puppy and the severity of the incongruency and abnormal shape of the hip joint are important in how well any particular puppy will do with early surgical intervention.

If hip dysplasia is not recognized in time or is not treated with Pubic Fusion or Pelvic Osteotomy in time, severe, painful, crippling arthritis may occur. Once the advanced stages of arthritis are present, whether it be from hip dysplasia or another cause, other surgical procedures, such as total hip replacement, may be required to salvage pain-free use of the affected leg.

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