VetSRev
Database of veterinary systematic reviews
Database of veterinary systematic reviews
Veterinary Evidence (2022) 7:
DOI: 10.18849/VE.V7I1.388
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.
Rehnblom, E., & Gordon-Evans, W. J. (2022). Are dogs with hip dysplasia in less pain after total hip replacement than femoral head ostectomy? Veterinary Evidence, 7(1). https://doi.org/10.18849/VE.V7I1.388 Dogs, systematic reviews, therapy, surgery, bones, osteoarthritis, pain, abnormalities, exercise, gait, joint diseases, clinical examination, Arthroplasty, Replacement, Hip, dysplasia, Hip Dislocation, hip dysplasia, hips, prostheses, radiography