Hip dis­lo­ca­tion in dogs

Wangaratta Chronicle - North East Regional Extra - - News - Tim Craig BVSC, vet­eri­nar­ian

THE hip joint is a strong ball and socket joint join­ing the hind limb to the pelvis.

As such, any ac­ci­dent that dis­lo­cates the hip joint must cause sig­nif­i­cant dam­age to the mus­cles, joint cap­sule and lig­a­ments that keep the hip joint to­gether.

In some cases if the dog is lucky the head of the fe­mur (ball) can be put back in the ac­etab­u­lum (socket) promptly and with sup­port for sev­eral weeks the dam­aged tis­sues heal suf­fi­ciently to al­low the joint to stay to­gether and for nor­mal use to re­turn.

Un­for­tu­nately in many cases of hip dis­lo­ca­tion, ei­ther fail­ure to seek prompt treat­ment or the de­gree of dam­age to the sup­port­ing struc­tures leads to a sit­u­a­tion where the joint re­mains un­sta­ble and re-dis­lo­cates.

In th­ese cases a sur­gi­cal ap­proach is re­quired to help keep the joint in place.

There are var­i­ous tech­niques that can be em­ployed to help put the hip joint back to­gether and keep it that way.

The most use­ful in medium to larger dogs is the tog­gle pin tech­nique that uses a metal tog­gle and su­ture to repli­cate the round lig­a­ment’s job of at­tach­ing the head of the fe­mur to the hip.

A small hole is drilled through the hip socket and a metal tog­gle with at­tached su­ture is pushed through.

This tog­gle is long and nar­row and can be fed through the hole then jig­gled 90 de­grees to make it un­able to pass back through the small hole (this is the same con­cept as plac­ing a but­ton through a but­ton­hole).

The su­ture is then fed through a hole drilled in the femoral head and fixed to the fe­mur thus form­ing a solid re­tainer for the ball in the socket.

In medium to larger dogs where the car­ti­lages of the ball and socket have not been badly dam­aged this method usu­ally leads to nor­mal func­tion af­ter re­cov­ery from the surgery.

This tech­nique can be em­ployed in smaller dogs, but is much more dif­fi­cult due to the smaller size of the hip joint.

In smaller dogs (un­der 10kg) the usual ap­proach is to per­form a pro­ce­dure called an ex­ci­sion arthro­plasty where the head of the fe­mur (ball) is re­moved and soft tis­sues are stitched be­tween the smoothed off up­per part of the fe­mur and the socket on the hip.

Over time with some fi­brous tis­sue de­po­si­tion a “false” joint or fi­brous joint is cre­ated that works well in lighter pa­tients through­out their life.

If there has been sig­nif­i­cant dam­age to the hip joint or if the dis­lo­ca­tion has been partly due to a poorly formed hip joint then to­tal hip re­place­ment surgery is a pos­si­bil­ity to fix the hip dis­lo­ca­tion.

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