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Hip replacement is a surgical procedure performed in dogs and cats as a salvage procedure, to alleviate severe pain in the hip due to, for example, hip dysplasia or irreparable bone fracture. [1] [2] The procedure replaces the head of the femur and the acetabulum with prosthetic implants. [1] Because animals under about 40 pounds (18 kg) carry their own weight with little strain on each leg, hip modification surgeries are often sufficient to restore hip function in many cases. As a result, while hip replacement on animals can be seen in any animal of any size, from cats upwards, it is most often performed in the medium-large breeds of dogs.
An animal suffering from hip dysplasia may have been in some degree of chronic pain all its life from a very young age but may show no overt sign of pain. Rather, they have adapted to the pain over an extended period, and learned to live with it. As a result, in many animals, successful hip replacement gives animals a level of playfulness and happiness not previously seen.
As with all surgeries, results vary, and there is both risk and uncertainty involved.
Animal hip replacements are usually made from the same material as human replacements were, historically, made—a metal (cobalt chrome or titanium) femoral component, and an ultra high molecular weight polyethylene acetabular component.
Since animals have a shorter life than humans, their hip replacements can safely be assumed to be lifelong and will not wear out or need replacing. By contrast, human hip replacements are sometimes deferred until older, to avoid the possible need for replacement later on in life.
Other treatments may give a good quality of life with fewer attendant risks. Surgery for dogs, as with humans, is a final alternative when non-invasive methods are unable to treat a condition, since they are irreversible and carry risk. Conditions such as hip dysplasia and arthritis can often be treated with appropriate medications that help the body handle pain, inflammation, or joint wear and tear.
Animals which are prospective candidates for hip replacement should have no other spinal, neural, or rear leg abnormalities, in order to be significantly helped by a hip joint procedure.
Since the reduced joint mobility seen in conditions such as dysplasia may result in loss of muscle mass and quality as a dog ages, there is often an advantage in having hip replacement whilst the dog is at an early age, while muscle is more likely to re-develop, rather than in old age when convalescence is longer and more difficult. However, this is a major surgery taking several months to fully recuperate, involving the large muscle groups of the hips, and is irreversible. Whilst it has a high success rate (circa 95%) in the hands of a good surgical team, even in older dogs, it is therefore often recommended to avoid it until quality of life is seriously affected beyond the capability of medication to control.
Thus the benefits of hip replacement at a younger age must be set against the risks and the existing quality of life attainable with medication, lifestyle change, or non-surgical handling. Usually a course of medications is tried in any event, to assess how the animal responds to them.
An animal will usually need a minimum of 2 months convalescence to recover from hip replacement surgery. This allows the new artificial acetabular cup (the caput, or hip socket) to bond properly to the pelvis (hip bone). During this period, the animal must be restricted to carefully limited mobility and exercise, as the joint is still bonding and new bone is being laid down. So animals must be prevented from over exercise, or from climbing, jumping or putting any strain whatsoever beyond gentle use, on the joint. The animal must also be kept away from slippery or smooth flooring such as tiles, marble or polished wood since these put considerable lateral (sideways) strain on the hips. This can be a difficult process for a dog as many usual behaviors must be strictly prevented for this period. A pet crate may be a sensible precaution, if in doubt.
Usually, in the case of a double replacement (both hips), whenever possible one hip is operated on at a time and allowed to heal before the other is replaced. This ensures that there is always the maximum natural support during the healing process, although bilateral (double) hip replacements are possible and can be performed if appropriate.
Some vets will recommend hip replacement at any age over puberty, if suitable conditions are met. Others view it as a surgery to be avoided at all costs unless there is no alternative. The issue here appears to be threefold: consideration of cost, avoidance of surgery where possible, and historical reasons that this has usually in the past been a treatment afforded older dogs and not usually considered for young and middle aged animals or less advanced conditions.
Aftercare recommendations vary also. Some vets recommend as little as 1–2 days in hospital after replacement, others as much as 4–7 days. All vets agree that movement must be restricted for a significant time after surgery. Some suggest that normal activity can be resumed after 5 weeks, others state it is unsafe until after 8 weeks. In both cases, a cautious approach will probably do no harm, if there is doubt.
The first feline hip replacement in the New York area was performed in March 2007. [3]
In dogs, hip dysplasia is an abnormal formation of the hip socket that, in its more severe form, can eventually cause lameness and arthritis of the joints. It is a genetic (polygenic) trait that is affected by environmental factors. It is common in many dog breeds, particularly the larger breeds, and is the most common single cause of arthritis of the hips.
Neutering, from the Latin neuter, is the removal of an animal's reproductive organ, either all of it or a considerably large part. The male-specific term is castration, while spaying is usually reserved for female animals. Colloquially, both terms are often referred to as fixing. In male horses, castrating is referred to as gelding. An animal that has not been neutered is sometimes referred to as entire or intact.
Cherry eye is a disorder of the nictitating membrane (NM), also called the third eyelid, present in the eyes of dogs and cats. Cherry eye is most often seen in young dogs under the age of two. Common misnomers include adenitis, hyperplasia, adenoma of the gland of the third eyelid; however, cherry eye is not caused by hyperplasia, neoplasia, or primary inflammation. In many species, the third eyelid plays an essential role in vision by supplying oxygen and nutrients to the eye via tear production. Normally, the gland can turn inside-out without detachment. Cherry eye results from a defect in the retinaculum which is responsible for anchoring the gland to the periorbita. This defect causes the gland to prolapse and protrude from the eye as a red fleshy mass. Problems arise as sensitive tissue dries out and is subjected to external trauma Exposure of the tissue often results in secondary inflammation, swelling, or infection. If left untreated, this condition can lead to dry eye syndrome and other complications.
Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. Hip replacement surgery can be performed as a total replacement or a hemi (half) replacement. Such joint replacement orthopaedic surgery is generally conducted to relieve arthritis pain or in some hip fractures. A total hip replacement consists of replacing both the acetabulum and the femoral head while hemiarthroplasty generally only replaces the femoral head. Hip replacement is one of the most common orthopaedic operations, though patient satisfaction varies widely. Approximately 58% of total hip replacements are estimated to last 25 years. The average cost of a total hip replacement in 2012 was $40,364 in the United States, and about $7,700 to $12,000 in most European countries.
Onychectomy, popularly known as declawing, is an operation to remove an animal's claws surgically by means of the amputation of all or part of the distal phalanges, or end bones, of the animal's toes. Because the claw develops from germinal tissue within the third phalanx, amputation of the bone is necessary to fully remove the claw. The terms "onychectomy" and "declawing" imply mere claw removal, but a more appropriate description would be phalangectomy, excision of toe bone.
Arthroplasty is an orthopedic surgical procedure where the articular surface of a musculoskeletal joint is replaced, remodeled, or realigned by osteotomy or some other procedure. It is an elective procedure that is done to relieve pain and restore function to the joint after damage by arthritis or some other type of trauma.
The health of dogs is a well studied area in veterinary medicine.
Carprofen is a non-steroidal anti-inflammatory drug (NSAID) of the propionic acid class that was previously for use in humans and animals, but is now only available to veterinarians for prescribing as a supportive treatment for various conditions in only animals. Carprofen reduces inflammation by inhibition of COX-1 and COX-2; its specificity for COX-2 varies from species to species. Marketed under many brand names worldwide, carprofen provides day-to-day treatment for pain and inflammation from various kinds of joint pain, as well as post-operative pain.
Elbow dysplasia is a condition involving multiple developmental abnormalities of the elbow-joint in the dog, specifically the growth of cartilage or the structures surrounding it. These abnormalities, known as 'primary lesions', give rise to osteoarthritic processes. Elbow dysplasia is a common condition of certain breeds of dogs.
Hip scoring is a procedure used to determine the degree of hip dysplasia in dogs and other animals and reporting the findings in a standard way. The hip score is the sum of the points awarded for each of nine radiographic features of both hip joints.
Limb replacement (prosthesis) in animals is a well developed science and becoming more common. Organ replacement is rarer and much more difficult. The first pacemaker surgery on a dog was performed in 1968. About 300 pacemakers are implanted in dogs each year. Successful kidney transplants in cats have been around since the mid-1980s. Canine programs have been less successful due to the problems of immunosuppression. The way donor animals are treated remains a source of concern.
Veterinary surgery is surgery performed on animals by veterinarians, whereby the procedures fall into three broad categories: orthopaedics, soft tissue surgery, and neurosurgery. Advanced surgical procedures such as joint replacement, fracture repair, stabilization of cranial cruciate ligament deficiency, oncologic (cancer) surgery, herniated disc treatment, complicated gastrointestinal or urogenital procedures, kidney transplant, skin grafts, complicated wound management, and minimally invasive procedures are performed by veterinary surgeons. Most general practice veterinarians perform routine surgeries such as neuters and minor mass excisions; some also perform additional procedures.
PennHIP is a program which evaluates the quality of the hips in dogs. The program was established at the University of Pennsylvania School of Veterinary Medicine by Gail Smith in 1993, with the primary objective of reducing the prevalence of hip dysplasia in dogs. To assess a dog's hip joints, three radiographs (X-rays) are taken from different angles while the dog is under general anesthesia. Radiographs are submitted to the PennHIP for assessment, and are assigned a score, called a distraction index. Veterinarians must be trained members of the PennHIP Network in order to take radiographs for these assessments. The scheme is available through veterinarians in the United States and Canada. It was considered as the most evidence-based radiographic method to diagnose hip dysplasia.
A femoral head ostectomy is a surgical operation to remove the head and neck from the femur. It is performed to alleviate pain, and is a salvage procedure, reserved for condition where pain can not be alleviated in any other way. It is common in veterinary surgery. Other names are excision arthroplasty of the femoral head and neck, Girdlestone's operation, Girdlestone procedure, and femoral head and neck ostectomy.
Hip dysplasia is an abnormality of the hip joint where the socket portion does not fully cover the ball portion, resulting in an increased risk for joint dislocation. Hip dysplasia may occur at birth or develop in early life. Regardless, it does not typically produce symptoms in babies less than a year old. Occasionally one leg may be shorter than the other. The left hip is more often affected than the right. Complications without treatment can include arthritis, limping, and low back pain.
Pediatric spaying or neutering is defined as performing an ovariohysterectomy (spaying) or orchidectomy on a kitten or puppy between the ages of 6 and 14 weeks. Spaying and neutering are sterilization procedures which prevent the animals from reproducing. The procedures are also referred to as “gonadectomies” in the veterinary literature.
Feline idiopathic cystitis (FIC) or feline interstitial cystitis or cystitis in cats, is one of the most frequently observed forms of feline lower urinary tract disease (FLUTD). Feline cystitis means "inflammation of the bladder in cats". The term idiopathic means unknown cause; however, certain behaviours have been known to aggravate the illness once it has been initiated. It can affect both males and females of any breed of cat. It is more commonly found in female cats; however, when males do exhibit cystitis, it is usually more dangerous.
Physical therapy for canines adapts human physical therapy techniques to increase function and mobility of joints and muscles in animals. Animal rehabilitation can reduce pain and enhance recovery from injury, surgery, degenerative diseases, age-related diseases, and obesity.
Hip arthroscopy refers to the viewing of the interior of the acetabulofemoral (hip) joint through an arthroscope and the treatment of hip pathology through a minimally invasive approach. This technique is sometimes used to help in the treatment of various joint disorders and has gained popularity because of the small incisions used and shorter recovery times when compared with conventional surgical techniques. Hip arthroscopy was not feasible until recently, new technology in both the tools used and the ability to distract the hip joint has led to a recent surge in the ability to do hip arthroscopy and the popularity of it.
The ventral slot technique is a procedure that allows the surgeon to reach and decompress the spinal cord and associated nerve roots from a ventral route in veterinary medicine. There are also alternative ways to open the spinal canal from dorsal by performing a hemilaminectomy, but this often gives only limited access. Even when the main pathological changes evolve from the midline, it is necessary to choose a ventral approach.