Surgical Proceedure for Labrador Hip Dysplasia
There are several surgical procedures available depending on the age and the severity of the joint degeneration.
Triple Pelvic Osteotomy (TPO): TPO is a procedure used in young dogs usually less than 10 months of age that have radiographs that show severe hip laxity, but have not developed severe damage to the joints. The procedure involves a surgical breaking of the pelvic bones and a realignment of the femoral head and acetabulum restoring the coxofemoral weight-bearing surface area and correcting femoral head subluxation. This is a major surgery and is very expensive, but the surgery has been very successful on animals that meet the requirements.
Total Hip Replacement: may be the best surgical option for dogs that have degenerative joint disease as a result of chronic hip dysplasia. Total hip replacement is a salvage procedure that can produce a functionally normal joint, eliminate degenerative changes, and alleviate joint pain. The procedure involves the removal of the existing joint and replacing it with a prosthesis. To be a candidate for this procedure, the animal must be skeletally mature and is usually performed on dogs weighing at least 20 pounds. There is no maximum size limit. If both hips need to be replaced, there is a three-month period of rest recommended between the surgeries. As with the TPO surgery, this is a very expensive procedure but has had some very good results.
Femoral Head and Neck Excision: Femoral head and neck excision is a procedure in which the head of the femur is surgically removed and a fibrous pseudo-joint forms. This procedure is considered a salvage procedure and is used in cases where degenerative joint disease has occurred and total hip replacement is not feasible. The resulting pseudo-joint will be free from pain and allow the animal to increase its activity, however, full range of motion and joint stability are decreased. For best results, the patient should weigh less than 45 pounds, however, the procedure may be performed on larger dogs.
Juvenile Pubic Symphysiodesis: A new, less invasive surgery for treating hip dysplasia, called Juvenile Pubic Symphysiodesis, is currently being evaluated. This surgery prematurely fuses two pelvic bones together, allowing the other pelvic bones to develop normally. This changes the angle of the hips, lessening the likelihood of arthritis. Early diagnosis is critical, since the procedure must be done before 20 weeks of age, preferably 16 weeks.
Pectineal Myectomy: This is a somewhat controversial treatment for patients with chronic hip dysplasia. The pectineus is one of the muscles attaching the femur to the pelvis. By cutting and removing this muscle, the tension on the joint and joint capsule are reduced. This offers some pain relief for some patients, but does not slow the progression of the disease. There are possible complications with this procedure and with the introduction of the newer, better procedures. This surgery is rarely performed anymore.
