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Lucy's Bad Hip
Lucy is a beautiful, 3 year old Golden Retriever who came to us last month after sustaining an injury of unknown origin. Her owners had left Lucy in the
yard for the day, and when they got home, the found she could not use her back left leg. Lucy was obviously in pain when they found her, so they took her to the emergency clinic (we were closed at the time). The emergency veterinarian isolated the pain to her hip joint. She sedated Lucy and took radiographs and found that she had dislocated her hip.
Fortunately, the bones were not broken, the thigh bone had simply slipped out of the socket formed by the pelvic bones. The radiographs revealed that Lucy has poorly formed, shallow hips
(hip dysplasia) and so it took less force to dislocate her hips than a normal dog.
The owners brought Lucy and her x-rays to us in the morning to
see if we could salvage her hip and let her walk again. Upon examination, Lucy was walking only 3 legs and was very painful in the left hip. In order to allow Lucy to walk normally, the femur had to be replaced in the joint. Unfortunately, when we attempted this under sedation, the hip continued to pop back out. This happens most of the time after a luxation because the joint capsule; which had to rip in order for the femur to pop out of the joint, falls back into the acetabulum and interferes with the femoral head sitting properly in the joint.
Since we couldn't make the femur stay in the joint naturally, we had to turn to surgical intervention to help Lucy. Our choices were to try and save the hip joint by replacing the femur into the acetabulum and stabilizing it surgically, or to remove the head of the femur (the ball on the end) so that the bones would not be stuck on each other. The first surgery has a potential 20% failure rate and tends to be more expensive than the latter, however, it has the best chance of gaining normal function of the joint. The second procedure, called a femoral head excision arthroplasty, is sometimes necessary and tends to leave the dog with a comfortable hip and very reasonable gait.
We decided to try surgical reduction using a technique known as the "Toggle Rod Coxofemoral Reduction Surgery". In this surgery we recreate the round ligament which helps hold the femur in the acetabulum. The surgical technique is illustrated on the following page: Toggle Rod Coxofemoral Reduction Surgery"
Lucy was taken to surgery that morning and 2 hours later we had the hip properly reduced. The x-ray below shows the hip in place and you can see the "metal toggle" that is inside the pelvis holding the synthetic round ligament. (click on the x-rays for larger views).
Lucy was sent home a few days later with antibiotics and pain medication. She was kept in a crate for two weeks and by the time she came in for suture removal, she was walking on the leg with minimal pain. She will be kept on restricted activity for 4 more weeks and then she should be able to resume normal activity.