Hip Reduction in Dogs

Hip reduction is used to treat hip dislocation in dogs, clinically known as coxofemoral luxation. There are two types of hip reductions: closed and open. Closed hip reductions are a form of conservative treatment in which the veterinarian physically manipulates the dislocated hip back into place. This will require a short-acting anesthesia. Open hip reductions are a surgical procedure which is used to place the coxofemoral joint of the hip back into its normal position. The approach used will depend on the severity of the dislocation and whether or not hip dysplasia is present.

The procedure steps for both closed and open hip reductions are described below.

Closed Hip Reduction

1. The vet will administer a short-acting anesthesia before physically manipulating the coxofemoral joint back into place.
2. A sling, bandage, or wrap will be placed, which the dog will be required to wear for at least fourteen days.

Open Hip Reduction

The approach to this surgery will vary based on the expertise and preferences of the surgeon. A wide number of tools can be used to correct hip dislocation, including toggle rods, surgical anchors, prosthetic joint capsules, and De Vita pins. De Vita pins are not typically recommended. The following procedure steps describe the toggle rod approach.

1. Blood work is done to make sure it is safe for the dog to be anesthetized. The surgeon will then administer general anesthesia and analgesics before cleaning, shaving, and draping the operative area.
2. The skin is incised and the hip muscles retracted along their natural seams.
3. The surgeon will visualize and open the joint capsule.
4. Using a special drill, a hole will be created in the acetabular wall.
5. A “bone tunnel” is drilled through the femoral neck.
6. A toggle pin which is attached to heavy suture material will be threaded through the hole and bone tunnel.
7. The surgeon will adjust the placement of the hip until it is in the correct position.
8. The suture material is tightened and attached to another toggle pin, which is secured on the other side of the joint. This holds the joint in place.
9. The joint capsule is sutured prior to closure of the initial surgery site.
10. A sling, wrap, or bandage is placed, which the dog will need to wear for up to fourteen days.

The efficacy of hip reduction will vary based on the approach used and the underlying condition. Closed hip reduction carries a 50% success rate, although the prognosis is better provided that the condition is diagnosed and treated within seventy-two hours. If the hip dislocation occurs again after closed reduction has been utilized, surgery is generally recommended. Surgery carries a much better success rate of up to 90%. If the surgery is unsuccessful, dogs may need to undergo a second surgical procedure, either a total hip replacement or a femoral head and neck osteotomy (FHO).

Strict cage rest is required for up to six weeks after surgery. The sutures are removed within fourteen days, at which time the veterinarian will determine if it is safe to remove the sling. Exercise restriction is imperative for the healing process. Owners should follow their surgeon’s instructions regarding exercise restriction carefully. Most dogs will need to be restricted from normal exercise for up to three months. Dogs can be walked on a leash for a short period of time to relieve themselves. Eight weeks after surgery, the veterinarian will take x-rays to monitor healing. After the x-ray, the vet may recommend a gradual return to normal activity.

The cost of hip reduction in dogs may vary based on standards of living, additional costs incurred, and whether a closed or open approach is used. The cost of hip reduction in dogs ranges from $1,500 to $15,000, with an average cost of $2,500.

The primary complication of closed hip reduction is failure to resolve or recurrence of the condition. Complications with joint surgery are rare. However, complications are possible with any surgical procedure, and may include:

• Infection
• Delayed healing, usually attributed to an early return to normal activity
• Loosening or breakage of the implant
• Sciatic nerve damage
• Progression of degenerative joint disease

It is vital that owners follow all recovery instructions carefully. Returning to activity too early can cause the implants to loosen or break. This will require a second surgery to correct. Sciatic nerve damage is usually temporary, and infection is very rare with orthopedic surgeries.

Certain conditions, such as cancer and genetic hip dysplasia, cannot be prevented. However, the most common cause of hip dislocation in dogs is involvement in an automobile accident. Owners should monitor their dog’s outdoor activity carefully to ensure they are not struck by a vehicle. Owners of larger breeds should also avoid overfeeding, as this may contribute to hip dysplasia.