Open Reduction in Dogs

Open reduction of the hip joint is a surgical procedure performed in dogs when a hip luxation, which is a dislocation, occurs in the hip joint. A hip luxation happens when a separation of the head of the femur from the acetabulum occurs. The hip experiences significant trauma as a result of the hip becoming separated, as the round ligament and joint capsules are torn and hip muscles are also often damaged. Severe trauma in the pelvis is usually the cause of this type of injury, although less severe trauma, under the right circumstances, can also cause dislocation. 

Open reduction of hip luxation is performed surgically by a veterinarian under general anesthetic to correct the issue. Sometimes, hip luxation can be corrected with closed reduction, in which the hip is manipulated manually back into the correct position. This is typically attempted before the need for open reduction is determined. If closed reduction is not successful, a surgical open reduction will be performed to reduce the femoral head, allowing it to be placed into the acetabulum and secured with artificial ligaments. 

Your dog will need to fast from food prior to the administration of general anaesthetic for surgical open reduction of the hip. Your dog will be sedated, administered intravenous anesthetic, and a intubation tube will be placed to allow for gaseous anesthetic for the duration of the procedure. Painkiller will be administered during the procedure and post operatively. The site for surgical incision above your dog's hip joint will be shaved and cleaned antiseptically and surgical drapes used to maintain a sterile surgical site. An incision will be made, and subcutaneous tissue transected and moved aside to reveal hip joint structures. Blood vessels, muscles and ligaments will be moved aside to avoid damage. The femoral head will be surgically reduced and repaired to allow it to return to the acetabulum appropriately. Damaged tissue trapped in the acetabulum will also be removed. Holes will be drilled in the femoral neck and antebellum and pins, rods, screws or implants used as appropriate to allow artificial materials such as suture material or wires to be threaded through and secure the femoral bone back into the antebellum. Joint tissue, such as joint capsules, may also be repaired at this time. Various surgical techniques that may be used to achieve reduction and stabilization.

Once repair has been affected, incisions are closed and your dog is provided supportive care while recovering from general anesthetic.

Closed reduction is usually attempted before open reduction to address hip luxations and failure of closed reduction does not seem to have any negative impact on the success of subsequent open reduction. Open reduction for hip luxations is associated with fair to good success rates and the return of most dogs to functional soundness. 

Analgesics, anti-inflammatories, and sometimes antibiotics, will be prescribed to your dog post surgery. These should be administered as prescribed by your veterinarian. A bandage may be applied to the incision and should be kept cleaned and changed as directed. The incision will need to be monitored to ensure rupture or infection does not occur.

After open reduction in the hip your dog should have activity severely restricted for four to six weeks. Cage rest may be prescribed during the initial recovery period. The affected limb may be placed in a non-weight bearing sling, called an Ehmer sling, for a few days or up to a week post surgery, to ensure that healing occurs before an attempt at weight bearing on the limb. A return to normal activity should not take place for up to 3 months. During this time your dog should be kept on a leash when outside for bathroom breaks, and good footing in the house provided with the use of rugs or carpets. Hobbles may be placed to secure your dog's knees post surgery and prevent them from doing the “splits” during recovery.

Your veterinarian will follow up within 2 weeks for suture removal, and another follow-up should be conducted to provide an examination and assess healing at a later date.

Medical treatment such as anti-inflammatory drugs, and physiotherapy to prevent the development of osteoarthritis may be initiated in the long-term, as this is a common condition associated with open reduction in the hip. 

The cost of open reduction for hip luxation in dogs ranges from $1,000 to $5,000, depending on the degree of repair required, and the cost of living in your area. The cost of radiographs, medications, anesthetic, surgical procedure and hospitalization are factored into the cost of open reduction treatment.

Although complications are rare, infection or complications from anesthetic can occur.

Exercise needs to be severely restricted following open reduction surgery and requires a time commitment and supportive care from dog owners following this procedure.

Osteoarthritis is commonly seen, in over half of cases treated with open reduction, and will need to be addressed on a long-term basis.

Failure of surgical stabilizing structures or artificial ligaments holding the hip in place can occur. This generally happens when they rupture or come loose, if not implanted correctly, or if reinjured through activity. Restricting activity and ensuring appropriate techniques and surgical materials are used minimize this risk.

Sciatic nerve damage is possible, but usually resolves with treatment and rest.Although complications are rare, infection or complications from anesthetic can occur.

Exercise needs to be severely restricted following open reduction surgery and requires a time commitment and supportive care from dog owners following this procedure.

Osteoarthritis is commonly seen, in over half of cases treated with open reduction, and will need to be addressed on a long-term basis.

Failure of surgical stabilizing structures or artificial ligaments holding the hip in place can occur. This generally happens when they rupture or come loose, if not implanted correctly, or if reinjured through activity. Restricting activity and ensuring appropriate techniques and surgical materials are used minimize this risk.

Sciatic nerve damage is possible, but usually resolves with treatment and rest.

Preventing accidents by keeping your dog restricted when outdoors, by leash or fencing, will help prevent the need for open reduction in dogs, motor vehicle accidents are the most common cause of hip luxations. Ensuring your dog has good footing and is not likely to slip or fall in their environment also prevents hip luxations requiring treatment. Ensuring your dog gets plenty of exercise and an appropriate diet to maintain a healthy weight will prevent deterioration and stress on the hip joint which could contribute to hip luxations.