The typical overall complication rate following a THR varies with patient factors and surgeon skill and expertise. The more commonly reported complications include postoperative luxations (often associated with a fall or excessive activity during the first 2–3 weeks following surgery), femoral fissure or fracture, sciatic nerve neuropraxia, and infection. Most surgeons report an overall average complication rate of 5–10% (1). The majority of complications are manageable, but may require additional surgery and incur associated costs. As with any surgical procedure, anesthesia can pose some risks.

Medical therapy may be effective for some patients but can have limitations and is not without some potential risks. Medical therapies are aimed at reducing the symptoms of joint pain, but do not address the underlying disease. Over time, osteoarthritis is expected to be progressive, resulting in a loss of joint function, reduced patient mobility, and worsening discomfort. It requires the pet parent to comply with lifelong and potentially costly medications, diet recommendations, and therapies. Certain patients may be difficult to effectively treat medically, such as cats and patients with underlying comorbidities. THR surgery is typically a one time procedure that restores a pain-free joint with normal function. After a complete recovery, patients can resume regular activities, even return to agility, work, and sporting activities. Over the lifetime of a patient, the cost difference between a single surgical procedure and a lifetime of medical therapies may be comparable.

There are two other surgical treatment options for hip dysplasia and other hip-related conditions:

• Double or triple pelvic osteotomy (DPO/TPO): In this procedure, the pelvis is cut in two (DPO) or three (TPO) locations to laterally and ventrally rotate the acetabular segment to improve the overall coverage of the femoral head and stability of the coxofemoral joint. It is only an option for young dogs (usually <10 months of age) where the joint structures are near normal, there is limited to no evidence of degenerative osteoarthritis, and the severity of subluxation is not extreme.
• Femoral head ostectomy (FHO): This procedure converts the bony “ball-and-socket hip joint” to a muscular joint or pseudoarthrosis. Although relatively simple to perform, it should be considered a salvage procedure and reserved for patients where this is the only option for addressing an abnormal hip joint. Studies have confirmed that return to function following an FHO is not guaranteed. Recovery can take several weeks and often results in significant limb shortening, loss of hip joint range of motion, persistent muscle atrophy, and persistent hip pain (1,2,3).

THR is regarded as the gold standard treatment because it restores normal function to the hip joint and alleviates the pain and discomfort associated with hip dysplasia, osteoarthritis, and other hip conditions. More than 90% of dogs undergoing THR are expected to regain normal function and maintain it for the rest of their lives (4).

A comparison chart of these treatment options can also be found here.

With advances in technology and techniques, today’s THR implants are designed to last for the lifetime of the pet. Learn more about these advances here.