Hip Dysplasia

Question 1

What 3 breeds most commonly are associated with hip dysplasia?

Answer 1

1. GSDs
2. Golden Retrievers
3. Labrador Retrievers

Question 2

What are 4 signs on physical exam indicative of hips dysplasia?

Answer 2

1. pain on extension of hips
2. positive Ortolani test performed under sedation
3. palpable crepitation on hips
4. bunny hop gait

Question 3

How does the Ortolani test work?

Answer 3

it subluxates the hip and induces a “pop” as the femoral head returns to the acetabulum

• never elicited in a normal dog, always done under sedation

Question 4

How are radiographs taken when assessing for hip dysplasia? What are 5 things seen on radiographs?

Answer 4

hip extension ventro-dorsal and lateral pelvic (under sedation)

1. Morgan line - osteophyte formation at insertion of the joint capsule
2. less than 50% coverage of the femoral head
3. remodeling, sclerosis, and thickening of the femoral neck
4. perichondral osteophyte formation
5. remodeling and sclerosis of the acetabulum

Question 5

What are 4 parts to conservative medical management in cases of hip dysplasia?

Answer 5

1. NSAIDs for discomfort - Carprofen, Deracoxib, Firocoxib, Tepoxalin (monitor kidney and liver values)
2. weight management
3. chondroprotectants - glucosamine, chondroitin, glycosaminoglycans may slow ongoing damage
4. conservative exercise - low impact walking, swimming

Question 6

What are 5 options for treating hip dysplasia?

Answer 6

1. juvenile pelvic symphysiodesis
2. triple pelvic osteotomy (TPO)
3. total hip replacement
4. femoral head and neck ostectomy (FHO)
5. denervation of hip joint capsule

Question 7

What is a juvenile pelvic symphysiodesis? When is it performed?

Answer 7

cauterization or stapling of the growth plate of the pelvis to encourage more acetabular coverage of the femoral head as the dog (with hip dysplasia) grows

14-20 weeks of age

Question 8

Should a juvenile pelvic symphysiodesis be performed on a patient with severe hip dysplasia?

Answer 8

no - DJD will also still progress

Question 9

What 3 cuts are performed during a triple pelvic osteotomy (TPO)? When is it performed?

Answer 9

1. pubis
2. inschium
3. ilium
   + placement of a plate to rotate the pelvis to increase acetabular coverage of the femoral head as the patient ages

6-12 months

Question 10

What problem is associated with total hip replacements when correcting hip dysplasia? When is this most commonly performed?

Answer 10

complete failure of the implant leads to an FHO anyways

anytime once the growth plates are closed, does not matter with the progression of hip dysplasia since the prosthetic forms a new joint

Question 11

What is a femoral head and neck osteotomy? What is a possible complication? When is this procedure preferred?

Answer 11

removal of the head and neck of the femur, resulting in a “pseudo-joint” to treat hip dysplasia

• salvage procedure in cases with severe dysplasia
• smaller animals weighing <20-30lbs

Question 12

How does denervation of the hip joint capsule work for treating hip dysplasia?

Answer 12

denervation of the capsule allows the dog to not feel pain even though hip dysplasia is still progressing

Question 13

What are 2 ways to prevent hip dysplasia?

Answer 13

1. avoid over-nutrition during growth
2. conscious breeding with Penn Hip and OFA Hip screening