Hip Dysplasia Surgical Option 4. Total Hip Replacement

Question 1

What is a total hip replacement

Answer 1

This is where the hip joint surface is replaced with a new prosthetic ball and socket in the femur and hip joint (acetabulum). It is designed to fit precisely and will mimic the normal anatomy of the joint.

Question 2

Patient Prep

Answer 2

The patient is clipped from the dorsal midline of the affected side to the base of the tail and then down to the tarsus, including the circumference of the limb (see image below). In this image you will note that the affected side of the animal must be fully clipped.

Question 3

Patient Positioning

Answer 3

The patient is placed in lateral recumbency with the affected limb uppermost and suspended for draping.

Question 4

Instruments / materials

Answer 4

Four quarter drapes, osteotome, mallet (or oscillating saw), listen bone cutters, muscle and joint retractors, a general surgical kit, the custom prosthetics and any associated equipment.

Question 5

Surgical Procedure of total hop replacement

Answer 5

This procedure is highly advanced and can only be performed by trained personnel. This procedure should be done as late in life as possible, when all other means have failed. This is because the prosthetic joint is in a constant state of degeneration and by doing this procedure later in life prevents the potential need to replace the original hip prosthesis. Total hip replacement falls into two categories; cemented or cementless (pressfit). Cemented uses cement to fill the acetabulum out to a smooth shape, whereas a press fit uses a cup to be pressed into the acetabulum which allows bone ingrowth. Both options are used universally and have their advances and disadvantages.

Question 6

Post op care of total hip replacement

Answer 6

Activity should be supervised and limited to leash walks for 6 weeks.