Relief from Chronic Pain
What is a Total Hip Replacement?
- A Total Hip Repacement (THR) is a prosthetic hip that is implanted in a similar fashion as is done in people to completely replace a painful arthritic joint.
- The Biomedtrix® modular prosthetic hip replacement system used at CARE has three components – the femoral stem, the femoral head, and the acetabular cup.
- The components are made of titanium, cobalt chrome and ultra high molecular weight polyethylene.
- Both cementless and cemented implants are available.
- The Biomedtrix microhip system is now available. This allows Total Hip Repacement to be performed in all sizes of dogs and cats
Why Choose a Total Hip Replacement?
- THR’s are performed to relieve pain, improve the hip function and allow your dog to return to an active life. The arthritic joint is replaced with the implant so the pain of bone rubbing on bone in the arthritic joint is gone.
- The decreased range of motion of the arthritic joint is also improved to allow a good range of motion and joint flexibility.
How Do Dogs Feel with a Total Hip Replacement?
- Most dogs walk on their new hip immediately after surgery.
- Gradual return to normal function is allowed between 8 and 12 weeks after surgery.
- Most pet owners report their dog’s personality gait and quality of life improves
- A long-term study found THR to be a very effective method of treating disabling conditions of the canine hip. The majority of dogs displayed marked improvement in walking, sitting, climbing stairs, standing, running, getting into cars, playing and exercise following surgery.
- THR’s have been performed in both pet and working dogs with equal success.
- The life of a THR in people is approximately 10-15 years.
- Replacement of implants due to wear and tear is rarely necessary in dogs partly because dogs weigh less than people, their weight is distributed on four rather than two legs, and their average life span is considerably shorter.
Should Both Hips Receive a Total Hip Replacement?
- Only one hip can be done at a time. The most painful hip should be replaced first.
- If pain is present on both sides, both sides should be replaced. The interval between surgeries is at least two months.
- However, over 80% of dogs do NOT need a second surgery despite the presence of arthritis in the other hip.
What Do Dogs Go Through to Get a Total Hip Replacement?
- The surgery typically takes 120 – 180 minutes.
- Patients under continuously monitored general anaesthesia. Vital parameters, such as heart rate, heart rhythm, tissue perfusion, respiratory rate and pattern, temperature and blood pressure are monitored.
- The surgery is performed with extensive precautions to prevent infection.
- Much attention is paid to preoperative preparation of the patient, instrument preparation, aseptic technique and environment control in the operating room.
- Pain medication is administered preoperatively, intraoperatively and maintained as long as needed.
- The patient is hospitalised with 24 hour patient care. A vet is present in the hospital at all times
- The dogs routinely support some weight immediately post operatively. They are generally released from the hospital one to three days after surgery.
What is the Aftercare?
- See separate sheet
What is the Success Rate with a Total Hip Replacement?
- Total hip replacements have been successfully performed in canine patients since 1974 and have enjoyed excellent results.
- Over 85% of patients return to normal function after the surgery. Most dogs will run, jump, play normally, and have an improved quality of life.
Are There Any Risks?
- The success rate is approximately 90% – which means there is approximately a 1 in 10 chance of complications.
- Risks exist just as they do for surgery on people. Complications from infection, implant rejections, dislocation, technical problems, and anaesthesia can never be totally eliminated. Extreme precautions are taken to minimise problems with infection and anaesthesia.
- The full list of complications are luxation (dislocation), infection, aseptic loosening (loosening without infection), fracture, implant displacement, sciatic neuropraxia (stretching or bruising of the sciatic nerve by retraction), patella luxation (dislocation of the kneecap), embolism (fat, bone cement) to the lungs (very rare).
- Sometimes complications can be resolved successfully without further surgery (eg. sciatic neuropraxia). Sometimes revision surgery is required to address complications (eg. fracture).
- In some cases the problem can’t be resolved until implants are removed. In this situation the gluteal muscles forms a false joint over the femoral shaft similar to femoral head and neck excision surgery. Final function following this is equivalent to if femoral head and neck excision were performed initially. Femoral head and neck excision is a salvage procedure where the femoral head and neck are removed. This prevents bone on bone contact and can be effective at reducing pain. Final function may be better than prior to surgery but is not as good as if successful total hip replacement is performed.
When Should the Surgery be Performed?
- Surgery is typically recommended when pain or lameness if present and conservative management (controlled exercise, weight loss, anti-inflammatories) is proving ineffective.
- Long delays in performing surgery can lead to longer rehabilitation time. THR is ideally performed before atrophy of hind limb muscles occurs. Additionally, a delay means less time for your dog to enjoy the improved pain free function provided by the hip replacement.
- For cases where complete luxation (dislocation) of the hip is present secondary to hip dysplasia, surgery may be recommended at a young age (as early as 9 months).
Call us on (03) 94176417 or through this form to discuss your pet’s needs. Learn about out Expert surgical team HERE.