Speaking with clients about hip dysplasia (Proceedings) - Veterinary Healthcare
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Speaking with clients about hip dysplasia (Proceedings)


CVC IN KANSAS CITY PROCEEDINGS


Total hip replacement

Total hip replacement can yield excellent postoperative results. Implants are secured either with cement or by a biologic "press fit" where bony ingrowth occurs in beads on the implant. Although there is currently no comparative study on long term loosening of cemented versus press fit hips, the assumption is that very young dogs (those 12 to 18 months of age) are likelier to avoid loosening problems long term with a press fit hip. Many surgeons still have a greater degree of experience with cemented hips and newer cementing techniques produce very good results. In a recent study of cemented total hip replacement, the overall complication rate was 12 %. Luxation occurred in 7 % of cases and aseptic loosening in 2 %. Clients need to be aware of potential complications. Luxation between the femoral head and acetabular components can occur and is at highest risk within the first 40 days after surgery. If this complication occurs it is generally resolved by replacing the cup at a different angle. Infection is the worst complication to occur because it requires removal of implants. The risk of infection is extremely low. Dogs must be scrutinized for any pre-existing infection prior to surgery. Skin, ear, dental or urinary tract infections are diagnosed and treated prior to surgery.

Femoral head and neck ostectomy

Femoral head and neck ostectomy is a salvage procedure for hip pain. Dogs can do very well with an FHO. Good results require postoperative rehabilitation. Range of motion exercises to maintain joint extension are very important. Postoperative walking, swimming or underwater treadmill are also advised. NSAID therapy is recommended for approximately 6 weeks after FHO. In my experience it can take 6 months to have very good walking on the operated leg whereas a THR yields a faster return of function. Larger breed dogs can also do well with an FHO with postoperative rehabilitation.

References

Guest editorial. Food for thought on canine developmental orthopedic disease. Vet Surg 35:211-13, 2006.

Todhunter RJ et al. Onset of epiphyseal mineralization and growth plate closure in radiographically normal and dysplastic Labrador retrievers. JAVMA 210:1458-62,1997.

Madsen JS. The joint capsule and joint laxity in dogs with hip dysplasia. JAVMA 210:1463-65,1997.

Kealy RD et al. Effects of limited food consumption on the incidence of hip dysplasia in growing dogs. JAVMA 201:857-63, 1992.

Impellizeri J et al. Effect of weight reduction on clinical signs of lameness in dogs with hip osteoarthritis. JAVMA 216:1089-91, 2000.

Lust G et al. Effects of intramuscular administration of glycosaminoglycan polysulfates on signs of incipient hip dysplasia in growing pups. AJVR 53:1836-43, 1992.

Clegg DO et al. The efficacy of glucosamine and chondroitin sulfate in patients with painful knee osteoarthritis: the glucosamine/chondroitin arthritis intervention trial (GAIT). In proceedings, American College of Rheumatology Annual Scientific Meeting 2005.

Bauer JE. Responses of dogs to dietary omega-3 fatty acids. JAVMA 231:1657-61,2007.

Patricelli AJ et al. Juvenile pubic symphysiodesis in dysplastic puppies at 15 and 20 weeks of age. Vet Surg 31:435-44, 2002.

Johnson AJ et al. Triple pelvic osteotomy: Effect on limb function and progression of degenerative joint disease. JAAHA 34:260-64, 1998.

Rasmussen LM et al. Preoperative variables affecting long term outcome of triple pelvic osteotomy for treatment of naturally developing hip dysplasia in dogs. JAVMA 213:80-85, 1998.

Ota J et al. Short term loosening of the femoral component in canine total hip replacement: effects of cementing technique on cement mantle grade. Vet Surg 34:345-52,2005.


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