DOI
https://doi.org/10.18849/ve.v7i1.388Abstract
PICO question
In large breed juvenile dogs with hip dysplasia and radiographic bilateral osteoarthritis, is a total hip replacement superior/inferior/or equivalent to bilateral femoral head ostectomy at reducing the severity of long-term hip pain?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
Twelve papers were critically appraised. One paper was a systematic review. Six papers were prospective case series. Five papers were retrospective case series
Strength of evidence
Weak
Outcomes reported
Besides one systematic review, there are no other studies available that directly compare pain reduction with total hip replacement and femoral head ostectomy for the treatment of hip dysplasia in large breed juvenile dogs with radiographic evidence of secondary osteoarthritis. In one study, 12/12 (100%)of owners that responded to an owner outcome questionnaire reported no hip pain with femoral head and neck ostectomy. In this study, owners assessed pain based on activity level of the dog (running, playing, jumping, using stairs normally), gait abnormalities (only when running or after strenuous exercise), and duration of postoperative medications. In eight studies, 91–100% of cases had no hip pain with total hip replacement reported via clinical examination and/or owner outcome questionnaire
Conclusion
There is evidence suggesting that both total hip replacement and femoral head ostectomy may be capable of reducing long-term pain as a result of osteoarthritis, secondary to hip dysplasia, however, based on the current literature, it is challenging to say whether total hip replacement is superior to femoral head and neck ostectomy at reducing long-term hip pain. It is important to recognise that other factors considered as outcomes (i.e. range of motion, ground reaction forces, force-plate analysis, etc.) may contribute to differing outcomes overall for total hip replacement vs femoral head ostectomy, but this paper focused specifically on pain. While there is a systematic review that provides evidence supporting that total hip replacement is superior at returning dogs to normal function, evaluating return to normal function was not the focus of this Knowledge Summary
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
References
Bayer, K., Matiasovic, M., Steger, H. & Böttcher, P. (2019). Complications and Long-Term Outcome in 16 Canine Cementless Hybrid Hip Arthroplasties. Veterinary and Comparative Orthopaedics and Traumatology.32(1), 73–78. DOI: https://doi.org/1055/s-0038-1676072
Bergh, M. S. & Budsberg, S. C. (2014). A Systematic Review of the Literature Describing the Efficacy of Surgical Treatments for Canine Hip Dysplasia (1948–2012). Veterinary Surgery.43(5), 501–506. DOI: https://doi.org/10.1111/j.1532-950X.2014.12208.x
Budsberg, S. C., Chambers, J. N., Lue, S. L. van, Foutz, T. L. & Reece, L. (1996). Prospective evaluation of ground reaction forces in dogs undergoing unilateral total hip replacement. American Journal of Veterinary Research. 57(12), 1781–1785.
Dueland, R., Bartel, D. L. & Antonson, E. (1977). Force-plant technique for canine gait analysis of total hip and excision arthroplasty [proceedings]. Journal of the American Animal Hospital Association. 13(5), 547–552.
Duff, R. & Campbell, J. R. (1977). Long term results of excision arthroplasty of the canine hip. The Veterinary Record. 101(10), 181–184.
Fitzpatrick, N., Law, A. Y., Bielecki, M. & Girling, S. (2014). Cementless Total Hip Replacement in 20 Juveniles Using BFX™ Arthroplasty. Veterinary Surgery.43(6), 715–725. DOI: https://doi.org/10.1111/j.1532-950X.2014.12214.x
Ganesh, T. N., Siobhan Bridglalsingh & Legall, C. (2017). Femoral head and neck excision arthroplasty in 38 dogs: a two-year study with special reference to surgical indication and outcome. Indian Journal of Veterinary Surgery, 38(2), 77-80. [online] Available from: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=caba6&NEWS=N&AN=20193238298 [Accessed ]
Gemmill, T. J., Pink, J., Renwick, A., Oxley, B., Downes, C., Roch, S. & McKee, W. M. (2011). Hybrid Cemented/Cementless Total Hip Replacement in Dogs: Seventy-Eight Consecutive Joint Replacements. Veterinary Surgery.40(5), 621–630. DOI: https://doi.org/10.1111/j.1532-950X.2011.00827.x
Guerrero, T. G. & Montavon, P. M. (2009). Zurich Cementless Total Hip Replacement: Retrospective Evaluation of 2nd Generation Implants in 60 Dogs. Veterinary Surgery.38(1), 70–80. DOI: https://doi.org/10.1111/j.1532-950X.2008.00466.x
Massat, B. J. & Vasseur, P. B. (1994). Clinical and radiographic results of total hip arthroplasty in dogs: 96 cases (1986–1992). Journal of the American Veterinary Medical Association. 205(3), 448–454.
Off, W. & Matis, U. (2010). Excision arthroplasty of the hip joint in dogs and cats. Clinical, radiographic, and gait analysis findings from the Department of Surgery, Veterinary Faculty of the Ludwig-Maximilians-University of Munich, Germany. 1997. Veterinary and Comparative Orthopaedics and Traumatology.23(5), 297–305.
Olmstead, M. L., Hohn, R. B. & Turner, T. M. (1983). A five-year study of 221 total hip replacements in the dog. Journal of the American Veterinary Medical Association. 183(2), 191–194.
Parker, R. B., Spencer, C. P., Bloomberg, M. S., Bitetto, W. & Rodkey, W. G. (1984). Canine total hip arthroplasty: a radiographic correlation of clinical results in 20 cases. Journal of the American Animal Hospital Association. 20(1), 105–113.
Rawson, E. A., Aronsohn, M. G. & Burk, R. L. (2005). Simultaneous Bilateral Femoral Head and Neck Ostectomy for the Treatment of Canine Hip Dysplasia. Journal of the American Animal Hospital Association. 41(3), 166–170. DOI: https://doi.org/10.5326/0410166
Vezzoni, L., Vezzoni, A. & Boudrieau, R. J. (2015). Long-Term Outcome of Zürich Cementless Total Hip Arthroplasty in 439 Cases. Veterinary Surgery. 44(8), 921–929. DOI: https://doi.org/10.1111/vsu.12371
License
Veterinary Evidence uses the Creative Commons copyright Creative Commons Attribution 4.0 International License. That means users are free to copy and redistribute the material in any medium or format. Remix, transform, and build upon the material for any purpose, even commercially - with the appropriate citation.
Most read articles by the same author(s)
- Hillary Mikulak, Wanda J. Gordon-Evans, Mortality rate comparison of enterotomy and resection and anastomosis (enterectomy) in dogs with foreign-body obstructions , Veterinary Evidence: Vol. 6 No. 4 (2021): The fourth issue of 2021
- Rachel T. Griffiths, Wanda J. Gordon-Evans, Uncomplicated gallbladder mucoceles – is it better for prognosis to perform cholecystectomy or medically manage? , Veterinary Evidence: Vol. 6 No. 2 (2021): The second issue of 2021
