Total Hip Replacement (THR)

Restoring Comfort, Mobility, and Quality of Life

Total hip replacement (THR) is a definitive surgical procedure designed to restore comfort, mobility, and quality of life in dogs (and some cats) affected by severe hip disease. By replacing the diseased components of the hip joint with prosthetic implants, this procedure aims to eliminate pain and re-establish normal or near-normal joint function. THR is most commonly recommended for dogs with advanced hip dysplasia and secondary osteoarthritis, but it is also an appropriate treatment for cases such as dislocated hips, previous fractures, and Legg-Calvé-Perthes disease. In appropriately selected patients, it is widely regarded as the gold standard surgical option for restoring limb function.

For Pet Owners

What does the procedure involve?

Total hip replacement involves removing the diseased portions of the hip joint and replacing them with prosthetic components that replicate the normal anatomy. The acetabulum, or socket of the pelvis, is fitted with a synthetic cup, while the femoral head and neck are replaced with a prosthetic stem and ball. These components are designed to articulate smoothly and provide a stable, pain-free joint. Depending on the specific case, implants may be secured using bone cement or through cementless techniques that allow bone to grow into the implant surface over time. The overall goal of the procedure is to restore comfortable, functional movement and eliminate the chronic pain associated with hip disease.

What outcomes can I expect?

Total hip replacement is associated with consistently excellent outcomes in dogs, and it is one of the most successful procedures in veterinary orthopedic surgery. The majority of patients experience a dramatic improvement in comfort and mobility, with many regaining normal limb use. Clinical studies have shown that most owners report a very high level of satisfaction following the procedure, with dogs returning to activities such as walking, running, and playing without the limitations imposed by chronic hip pain. Long-term data indicate that these improvements are durable, with implants maintaining function for many years in most cases. For many dogs, THR provides a return to a quality of life that would not be achievable with medical management alone.

What are the risks?

As with any major surgical procedure, total hip replacement carries some risk of complications. Reported complication rates vary depending on how they are defined, but major complications occur in a small percentage of cases. Potential complications include dislocation of the prosthetic joint, loosening or failure of the implants, fracture of the femur, infection, and, less commonly, nerve injury. While these complications can be serious, many can be successfully managed, and in some cases revision surgery can still result in a good long-term outcome. Careful surgical technique, appropriate patient selection, and strict adherence to postoperative care recommendations all play an important role in minimizing these risks.

What does recovery look like?

Recovery following total hip replacement is a critical component of achieving a successful outcome. In the immediate postoperative period, dogs require strict rest and close monitoring while pain is managed with appropriate medications. During the first several months, activity must be carefully restricted to controlled leash walks only, with no running, jumping, or rough play. As recovery progresses, activity is gradually increased as healing progresses and muscle strength improves. After three months, many dogs are allowed to return to normal activity levels. Owner compliance during this period is essential, as premature or excessive activity increase the risk of complications such as implant failure and fracture.

For Referring Veterinarians

Case Selection & Indications

Appropriate case selection is fundamental to the success of total hip replacement. Ideal candidates are dogs greater than 6 months of age, with clinical signs of significant hip pain. While medium to large breed dogs are most commonly treated, smaller dogs an cats can also benefit from the procedure in selected cases. Contraindications may include active infection, significant neurologic disease affecting limb function, inadequate bone stock or other boney anomalies or concurrent systemic illness that would increase anesthetic or surgical risk. In patients with bilateral disease, staged procedures can be performed to address each hip sequentially, allowing for recovery between surgeries.

Surgical Considerations

Total hip replacement is performed through a surgical approach that allows access to the hip joint while preserving surrounding structures as much as possible. The procedure requires precise preparation of the bone and accurate placement of the prosthetic components to ensure joint stability and minimize wear over time. Both cemented and cementless implant systems are widely used, with the choice depending on factors such as patient anatomy and bone quality.

Outcomes & Evidence Base

The effectiveness of total hip replacement in dogs is well supported by a substantial body of peer-reviewed literature. Multiple studies have demonstrated high rates of functional improvement and owner satisfaction following the procedure. Reported complication rates are relatively low, particularly for major complications, and long-term follow-up indicates that most implants continue to function well for many years. Importantly, outcomes are generally favorable even in more complex or challenging cases, further supporting the role of THR as a reliable and durable treatment option for severe hip disease. This strong evidence base underpins its position as a preferred surgical intervention in appropriately selected patients.

Postoperative Management

Postoperative management begins immediately after surgery with the use of multimodal analgesia to ensure patient comfort and facilitate early recovery. Strict activity restriction is essential, along with careful monitoring for any signs of complications such as implant instability or infection. Follow-up examinations and radiographic assessment are used to monitor healing and implant position. Clear communication with owners regarding the importance of compliance with postoperative instructions is critical, as this has a direct impact on the success of the procedure.

When to Refer

Referral for total hip replacement should be considered in patients with persistent hip pain that is not adequately controlled with medical management, particularly when quality of life is significantly affected. Radiographic evidence of advanced degenerative joint disease or subluxation of the joint, combined with clinical signs of discomfort or lameness, supports consideration of surgical intervention. Early referral can be beneficial in ensuring timely intervention and improved overall outcomes.

Why Consider Total Hip Replacement?

Total hip replacement offers several important advantages over other surgical options for managing severe hip disease. By restoring normal joint anatomy and biomechanics, it provides more predictable and superior functional outcomes compared to procedures such as double or triple pelvic osteotomies and femoral head and neck excision. This is particularly relevant in larger dogs, where alternative procedures may result in persistent gait abnormalities or reduced limb function. In addition to improving mobility, THR reliably alleviates chronic pain, making it a highly effective long-term solution for appropriately selected patients.

Summary

Total hip replacement is a highly effective and well-established surgical treatment for severe hip disease in dogs. Supported by extensive peer-reviewed evidence, it offers excellent functional outcomes, high levels of owner satisfaction, and durable long-term results. With careful patient selection, skilled surgical technique, and diligent postoperative care, THR provides a predictable and transformative improvement in both comfort and mobility, allowing many dogs to return to an active and pain-free life.

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