Hip Reduction in Cats

Hip reduction is used to treat coxofemoral luxation, or hip dislocation. There are two types of hip reduction in cats: open and closed. Closed hip reduction does not involve surgery. A short-acting anesthetic is administered while the surgeon physically manipulates the joint back into place. The limb may then be placed in a sling for additional support. Closed hip reduction is usually recommended as the first line of treatment, except in severe or chronic cases. Open hip reduction is a surgical procedure that involves placing the hip back into its socket. This may be achieved by inserting implants to support the hip and restore normal function. The type of hip reduction used will vary based on the severity of the dislocation.

The procedure steps may vary based on the approach used. The general procedure steps for both closed and open reductions are outlined below.

Closed Hip Reduction

1. A short-acting anesthetic is administered.
2. The veterinarian will manually placed back into its joint socket.
3. A sling, wrap, or bandage is applied to keep the joint in place. The cat will be required to wear it for up to fourteen days.

Open Hip Reduction

There are a variety of approaches to open hip reduction, including toggle rod fixation, surgical anchors, the placement of a prosthetic joint capsule, and De Vita pin insertion. The approach used will vary based on the expertise and preferences of the surgeon. The procedure steps below outline the toggle rod fixation approach.

1. Prior to surgery, blood work will be done to ensure anesthetization is safe for the cat.
2. General anesthesia and analgesics are then administered intravenously.
3. The operative area is cleaned, shaved, and draped.
4. The surgeon will make the incision into the skin and gently retract the muscles of the hip.
5. The joint capsule will be visualized and opened.
6. A special drill will be used to create a hole in the acetabulum wall. A “bone tunnel” is also drilled through the femoral neck.
7. The toggle pin, usually attached to a heavy suture material, is threaded through the hole in the acetabulum and the bone tunnel in the femoral neck.
8. The suture material is tightened, replacing the hip in its normal position, before being secured to another toggle pin.
9. The surgeon will ensure the hip is in the correct position before suturing the joint capsule and initial incision site.
10. The cat will need to wear a sling for up to fourteen days.

The efficacy of this procedure will vary based on the severity of the dislocation and the type of reduction used to treat it. Closed reduction has an average success rate of 50%. The rate of success is higher if the condition is diagnosed and treated within seventy-two hours. Open hip reduction has a success rate of 80% to 90%, and is considered highly effective in resolving recurrent and severe cases of hip dislocation. Cats usually make a full recovery from open hip reduction within three to four months.

Analgesics and anti-inflammatories will be prescribed upon discharge. A bandage may be applied to the incision site until it has healed. Cats will need to wear a sling for up to fourteen days, and will start bearing weight on the operated hip within a few days after the sling is removed. Strict cage rest is usually recommended for up to four weeks. Exercise should be restricted for three months after surgery. For the first two months, cats should not be allowed to walk on hard or slippery surfaces and should not go outside. After two months, cats can gradually begin to return to normal activity according to veterinary instructions.

Follow-up appointments will be scheduled for ten to fourteen days following surgery to remove sutures, and again eight weeks after surgery to take x-rays and monitor healing. 

The cost of hip reduction in cats will vary based on standards of living, additional costs incurred, and the type of hip reduction used. The cost of hip reduction may range from $500 to $3,500, with an average cost of $1,800.

Complications associated with hip reduction, although rare, may include:

• Infection
• Delayed healing as a result of premature return to activity
• Loosening or breakage of the artificial ligament or implant
• Damage to the sciatic nerve
• Severe progression of degenerative joint disease
• Anesthetic death

If the cat resumes normal activity too early after surgical treatment, it risks damaging the implant. Rectifying this may necessitate a more invasive procedure. Some of these complications will warrant a second surgery. Sciatic nerve damage is usually temporary. Infection is considered very rare in orthopedic surgeries.

Some conditions, such as hip dysplasia, are difficult or impossible to prevent. However, owners should monitor their cats and ensure they cannot engage in activities that may result in significant trauma to the hip joint.