Orthopedic Procedures

Arthroscopy is a minimally invasive technique used to evaluate and treat a variety of joint disorders. By using a small camera (arthroscope) and specialized instruments, this advanced procedure allows for precise visualization and treatment of joint problems, often resulting in less discomfort and faster recovery compared to traditional surgical approaches. Pets requiring arthroscopy are generally experiencing lameness, stiffness, or pain, and their condition may warrant advanced diagnostics before a definitive treatment plan is established.

Most arthroscopic procedures are performed as same-day outpatient surgeries, but recovery time and activity restrictions will vary based on the condition treated. Your pet’s surgeon will review all relevant details with you, including anticipated outcomes, postoperative care, and any potential complications.

Examples of conditions treated with arthroscopy:

• Elbow dysplasia, including fragmented coronoid process, OCD lesions, ununited anconeal process, and elbow incongruity
• Osteochondritis dissecans (OCD) of the shoulder, stifle, or hock
• Medial shoulder instability
• Bicipital tendonitis
• Septic arthritis (evaluation, biopsy, and lavage)
• Polyarthropathy (joint evaluation and synovial biopsy)

What is Canine Hip Dysplasia?

Canine Hip Dysplasia (CHD) is a common developmental orthopedic condition that can affect dogs of all ages, leading to pain, limited mobility, and arthritis. While the exact cause is unknown, genetics play a significant role. Dogs with CHD experience abnormal growth in the hip joint, leading to looseness (laxity) between the ball (femoral head) and socket (acetabulum). This laxity causes abnormal movement, which can damage the joint over time, resulting in arthritis and debilitating discomfort.

How CHD Develops

All dogs are born with healthy, tight hips, but those with CHD experience abnormal growth of the hip joint, resulting in laxity. The loose fit of the hip joint leads to abnormal motion. Over time, this abnormal motion causes wear and tear, leading to cartilage loss, scar tissue formation, and the development of painful bone spurs. Left untreated, the condition progresses to osteoarthritis, significantly impacting a dog’s quality of life. While genetics is the primary risk factor, rapid weight gain and overfeeding during growth periods can worsen the condition.

Signs and Symptoms of CHD

CHD can manifest differently depending on the dog’s age and disease progression. Common signs include:

• Limping or lameness
• Reluctance to rise, run, or jump
• Weight shifting to the front limbs
• Loss of muscle mass in the hind limbs
• Hip pain

Dogs with CHD generally fall into two groups:

• Young dogs with significant joint laxity but no arthritis
• Older dogs with arthritis caused by long-term hip joint instability

Diagnosing CHD

Diagnosing CHD involves:

• Palpation: Assessing hip joint laxity using physical examination techniques.
• Specialized X-rays: Sedated radiographs provide precise imaging of the hip joint.

For puppies, early screening through a PennHIP evaluation at 16 weeks can identify CHD before arthritis develops. Early detection allows for corrective treatments to improve long-term joint health and function.

Treatment Options for CHD

The ideal treatment depends on the dog’s age, size, and severity of CHD.

Young dogs without arthritis may benefit from:

• Juvenile Pubic Symphysiodesis (JPS): A minimally invasive procedure for puppies under 5 months old, this surgery modifies pelvic growth, improving hip socket coverage as the puppy matures.
• Double or Triple Pelvic Osteotomy (DPO/TPO): Suitable for dogs under 8–10 months old with no arthritis, a pelvic osteotomy involves surgically cutting and repositioning the pelvis to improve socket coverage and reduce laxity. Advances in technology now allow for DPO, which is less invasive than traditional TPO.

Older dogs with arthritis may benefit from:

• Total Hip Replacement (THR): The gold standard for restoring normal hip function in dogs with arthritis, THR replaces the ball and socket with metal and plastic implants, eliminating pain and providing a natural range of motion. This procedure is ideal for active dogs, including those who hunt, compete in agility, or enjoy high-energy activities.
• Total Hip Replacement (THR): The gold standard for restoring normal hip function in dogs with arthritis, THR replaces the ball and socket with metal and plastic implants, eliminating pain and providing a natural range of motion. This procedure is ideal for active dogs, including those who hunt, compete in agility, or enjoy high-energy activities.

Managing CHD

Early diagnosis and treatment can significantly improve a dog’s quality of life. For dogs not suited for surgery, medical management through weight control, joint supplements, and anti-inflammatory medications can help reduce symptoms.

For more information, download our Canine Hip Dysplasia Handout.

Please check out our Patellar Luxation Correction page for more information.

Regenerative medicine focuses on promoting healing and restoring function in damaged tissues. By leveraging the body’s natural healing processes, techniques like platelet-rich plasma (PRP) and stem cell therapy can reduce pain, improve mobility, and support recovery in pets with joint, muscle, or tendon injuries. These therapies are particularly beneficial for conditions where traditional treatments have limited success or are contraindicated.

Most regenerative medicine procedures are minimally invasive and can be performed on an outpatient basis. Your pet’s surgeon will discuss the recommended treatment plan, including the benefits, risks, and expected outcomes of each approach.

Platelet-Rich Plasma (PRP) Therapy

PRP therapy uses a concentrated solution of the patient’s own platelets and plasma to promote tissue healing and reduce inflammation. Platelets release growth factors that recruit cells to the site of injury, accelerating the repair process.

PRP therapy is often used for:

• Osteoarthritis in joints like the hip, elbow, stifle, or shoulder
• Tendon injuries, including biceps and Achilles tendinopathies
• Weight shifting to the front limbs
• Medial shoulder instability
• Supraspinatus tendinopathy

The procedure involves drawing a small amount of blood, processing it to isolate the platelet-rich plasma, and injecting it into the affected area. Depending on the condition, ultrasound guidance may be used for precision. PRP therapy typically requires multiple treatments, often spaced a few weeks apart, for optimal results.

Side effects are minimal and may include temporary discomfort or bruising at the injection site. PRP is often combined with other treatments, such as surgery or rehabilitation therapy, for a comprehensive approach to recovery.

Stem Cell Therapy

Stem cells are specialized cells with the ability to repair and regenerate damaged tissues. In veterinary medicine, mesenchymal stem cells (MSC) are commonly derived from bone marrow or fat and are particularly effective in treating orthopedic conditions.

Stem cell therapy is often used for:

• Osteoarthritis in dogs and cats
• Tendon and ligament injuries
• Immune-mediated polyarthritis
• Chronic inflammatory conditions (e.g., hepatitis or pancreatitis)

The procedure involves harvesting stem cells under general anesthesia, processing them to ensure purity, and injecting them into the affected area. Stem cells modulate inflammation, promote tissue healing, and may reduce pain.

Stem cell therapy is often recommended when traditional treatments, such as surgery or medications, are not viable options. Pets undergoing stem cell therapy for arthritis typically benefit from a multimodal approach, including weight management, chondroprotective supplements, pain management, and rehabilitation therapies like underwater treadmill or laser therapy.

While results vary, many pets experience improved mobility and reduced pain within 1-2 months of treatment. Frozen doses can be stored for future use, eliminating the need for repeat harvesting procedures.

Total hip replacement (THR) is a transformative procedure designed to alleviate pain and restore mobility for pets suffering from severe hip conditions. At VSC, our surgical team has over 30 years of experience performing THRs, making us one of the most trusted providers of this advanced orthopedic solution. Using the Biomedtrix THR System, we can perform successful THRs on cats and dogs of all sizes—from as small as 3 pounds to as large as 170 pounds.

Common Indications for THR

• Hip dysplasia and end-stage arthritis
• Hip dislocation
• Fractures of the femoral head or neck
• Legg-Calvé-Perthes disease (avascular necrosis of the femoral head)
• Physeal dysplasia with slipped capital femoral epiphysis (in cats)

Most pets over 9–10 months of age are eligible for THR. In giant breeds, we schedule surgery once they reach skeletal maturity at around 11–12 months.

The Process

1. Initial Consultation
THR is never performed on the same day as the initial appointment. During this first visit, you’ll meet with one of our surgeons to review your pet’s medical history, discuss symptoms, and perform a physical examination.

• Your pet will stay with us for a few hours while we take 4–6 sedated X-rays to assess the hip(s) and plan the surgery.
• We cannot use X-rays from your regular veterinarian, as we require specific views under sedation to measure and evaluate the joint properly.

2. Surgical Planning

• Once the X-rays are reviewed, we determine whether a THR is appropriate for your pet and which hip requires replacement if both are affected.
• In about 80% of cases, only one hip needs to be replaced to restore a good quality of life. This decision is based on X-rays, the surgeon’s physical examination, and your observations of your pet’s mobility.

3. Surgery

• Pets must be skeletally mature for THR (9–12 months of age, depending on breed size).
• During the procedure, the femoral head (ball) is removed, the acetabulum (cup) is prepared, and prosthetic implants are placed with precision to replicate the original joint anatomy and function.

4. Post-Operative Care

• Hospitalization: Pets stay for 1–2 days post-surgery, with higher-risk cases requiring longer stays for added monitoring.
• Activity Restriction: Most dogs begin using their limbs within days, but activity is limited to leashed bathroom breaks until healing is confirmed at 16 weeks.
• Incision Care:
  • Sutures are typically removed 10–14 days post-op.
  • Icing the leg can minimize swelling and discomfort.
  • An E-collar is critical to prevent licking or chewing, which could lead to infection.
• Follow-Up: Sedated recheck X-rays are taken at the six- and 12-week mark to monitor healing and determine the next steps.

Prognosis

Almost 80% of pets with hip dysplasia in both hips only require a THR on one side to achieve a good quality of life. We decide which hip to replace based on X-rays, the owner’s observations, and our physical examination. Over 95% of pets who undergo THR enjoy improved mobility for the rest of their lives. Following post-op instructions diligently is key to a full recovery and long-term success.

Please check out our TPLO page for more information about the procedure and aftercare.