Triple or Double Pelvic Osteotomy in Dogs

Your dog’s hip joints are made up of several different bone and tissue segments. When these segments are properly formed, and situated, your dog’s hips move freely and without pain. In some cases, the femoral head that makes up the top of your dog’s system of leg bones does not fit fully into the acetabulum, the circular-shaped pocket that makes forms a close-fitting cup over the femoral head. This condition is commonly referred to as hip dysplasia. Triple pelvic osteotomy (TPO) and double pelvic osteotomy (DPO) are two related procedures that can be used to improve coverage of the femoral head and correct hip dysplasia. 

Other, non-surgical, rehabilitative methods may be used to strengthen supporting muscles or otherwise correct hip dysplasia, however, the best results will occur if the surgery is performed as soon as possible before arthritic changes in the bone structure have begun to occur. Once this has happened, your dog is no longer a good candidate for surgical intervention.

Before surgery, your vet will perform several tests to confirm that your dog is a good candidate for the procedure. X-rays will need to be taken and your dog’s gait will need to be observed and their legs manipulated by a skilled orthopedic veterinarian. As with any major surgical procedure, your vet will ask for a complete blood profile prior to undergoing anesthesia. Your dog will be admitted to the veterinary hospital and will be placed under general anesthesia. A tube will be placed in your dog’s throat to allow for proper ventilation during surgery.

During the surgery, your vet will make a careful incision in the hip area to expose the femur and pelvis. In a TPO, three separate bone cuts are made using a surgical saw. These bone pieces are repositioned so that more complete coverage of the femoral head is obtained and your dog’s bone fits nicely into a reconstructed hip socket. The three fragments are resecured with the use of metal plates and screws. In a DPO, two cuts are made in the bone and the pelvis is rotated slightly to create a better angle for femur positioning. The bones are also secured with the use of specialty plates and screws. The next step in both procedures is to carefully close up the wound using stitches to reconnect underlying tissues and skin. Your dog is then carefully woken up from anesthesia and allowed to rest comfortably, at least overnight, for observation.

The effectiveness of a TPO or DPO will depend on many factors. Following proper rehabilitation protocols including confinement, rest, and gradual reintroduction to exercise, will be a critical element for long term success. Most patients will be able to move without pain or discomfort and the hip dysplasia will be corrected permanently.

As with any major joint surgery, proper rest, aftercare, and rehabilitation will be critical to your dog’s recovery. When released to home, your dog must be kept calm and quiet and movement should be restricted, strictly following your veterinarian’s instructions. Your veterinarian may prescribe pain and anti-inflammatory drugs to help provide for your dog’s comfort and to reduce postoperative swelling which aids in the healing process. 

After your dog’s incision has healed, you will be given instructions for returning gradually to normal exercise and movement. Your dog should be limited to on-leash walks only for at least several weeks. During recovery, rehabilitative exercises, such as swimming and slow stretching, may aid in returning to a normal range of motion and can help strengthen the surrounding muscles.

The overall cost of correcting hip dysplasia in your dog will include preliminary x-rays and diagnosis, which range from $300 to $800, plus the actual surgical procedure and post-operative care and rehabilitation. Triple or double pelvic osteotomy procedures cost about the same amount and range from $1,700 to $4,800 per hip. This range is due to many factors such as geographic location, size and weight of the dog, and complications found during surgery. The cost includes anesthesia, postoperative x-rays, and follow-up suture removal and x-rays to confirm metal plates have remained in place and the bone is healing well. 

For owners that cannot adhere to a strict home rehabilitation program, visits to a facility that specializes in this type of care can range from $50 to $100 per visit. Your dog may need 10 to 20 of these visits in order to make a full recovery. 

Surgery to correct hip dysplasia is not recommended for very young dogs under the age of five months as bone growth can continue for some time. For larger breeds that continue to grow well past a year, surgery may be postponed and supportive therapy may be offered until an accurate confirmation of hip dysplasia can be made once the structure of the joint is permanent. 

Surgery should not be postponed for an extended period of time as hip dysplasia can cause arthritic changes in the hip structure, which may make the dog a poor candidate for surgery. As with any major surgery, complications from infection or improper healing can occur in rare instances. Strict adherence to healing and therapy protocols are important for long term recovery.

The exact cause of hip dysplasia is not well known, however there are multiple likely contributing factors. In young dogs, quality nutrition is an important tool in preventing hip dysplasia. Overfeeding and excess weight can put undue stress and strain on developing bones and joints and young puppies should not be fat or overfed. 

There is some evidence that hip dysplasia has genetic components. All dogs being considered for breeding should undergo professional assessment of their hip conformation by a qualified veterinarian. Independent rating services such as OFA or PennHip offer evaluations of hip x-rays and provide a numeric ranking of hip socket placement. Dogs that are found to have hip dysplasia, even if asymptomatic, should be removed from breeding programs to avoid passing on these defects.