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WHAT IS A TRIPLE
PELVIC OSTEOTOMY?
Triple pelvic osteotomy means cutting the pelvis in
three places (see fig. 3). The osteotomies, or cuts, are performed to allow rotation of
the acetabulum into a better position over the femoral head. Thus, the femoral head is
"captured" within the acetabulum to stabilize the hip joint. A stainless steel
plate specifically designed for this procedure holds the repositioned acetabulum while the
osteotomies heal. (See fig. 5)
WHY PERFORM A TRIPLE
PELVIC OSTEOTOMY?
In puppies, the joint instability associated with hip dysplasia is
painful and disrupts normal development of the hip joint. A triple pelvic osteotomy is
performed to relieve pain, restore function, and stabilize the hip joint so it will
develop more normally. Studies in humans and in dogs show that if the abnormal
weight-bearing forces across the joint are corrected early in the course of hip
dysplasia, a more "normal" articulation will
develop. It is important to realize that the objective is to stabilize the hip joint to prevent the debilitating arthritis of chronic
dysplasia. The emphasis must be on early
detection and intervention before severe joint damage occurs.
IS YOUR DOG A CANDIDATE FOR A TRIPLE PELVIC OSTEOTOMY?
A triple pelvic osteotomy must be performed before arthritic changes
become too advanced. Ideal candidates are usually 5 to 8 months of age. Puppies of
susceptible breeds should be evaluated by their veterinarian by 6 months of age. Many 8-12
month-old dogs are still candidates, but most dogs older than 12 months of age are not.
Occasionally, dogs less than 8 months old are not candidates if their hip dysplasia is
severe. Some dogs may be a candidate in one hip but not the other. The most important criteria for candidate selection is hip palpation under general
anesthesia. Properly positioned radiographs taken under anesthesia are also mandatory.
Definitive patient selection and surgical planning (i.e., the number of degrees the
acetabulum will be rotated) are based on hip palpation by the surgeon immediately prior to
surgery. If both hips require reconstruction, surgery is performed on the most severely
affected side first. The second side is done 2 to 6 weeks later
WHAT
DO DOGS EXPERIENCE TO GET A TRIPLE PELVIC OSTEOTOMY?
The surgery takes approximately 90 minutes.
 Isoflurane general anesthesia is used. Vital parameters, such as
heart rate, heart rhythm, tissue perfusion, respiratory rate and
pattern, temperature and blood pressure are continuously
monitored. Detailed attention is paid to preoperative
preparation of the patient, instrument preparation, aseptic
technique, and environment control in the operating room. Pain
medication is administered postoperatively and maintained as
long as needed. The patient is hospitalized with 24-hour patient
care. The dogs routinely support some weight on the leg
immediately postoperatively. They are generally released from
the hospital one or two days following surgery.
WHAT CAN
I
EXPECT AFTER THE OPERATION?
Most dogs walk on their newly positioned hip joint
immediately after surgery. Patients should remain inactive for 6
weeks postoperatively. They should remain indoors, but allowed
outside on a leash to eliminate. Short
leash walks are allowed after 3 weeks. If
necessary, tranquilizers are prescribed. Gradual return to
normal activity is allowed between 6 and 8
weeks postoperatively.Most dogs show a significant improvement in attitude,
personality, and activity levels. In instances of severe
dysplasia, marked improvement in walking, sitting, climbing
stairs, standing, running, getting into the car, playing, and
performance can be expected. Most dogs lead a normal, active
life following TPO.
See Shadow's Story
ARE THERE ANY RISKS?
Yes. The incidence of complications is very low, but risks
exist just as they would for surgery on people. Complications
from infection, technical problems, and anesthesia can never be
totally eliminated. Extreme precautions to minimize infection
and anesthesia problems are taken. With owner and patient
compliance, complications rarely occur.
WHEN SHOULD THE
SURGERY BE PERFORMED?
Surgery options must be considered as soon as early hip
dysplasia is detected. Unless dysplasia is exceptionally severe,
patients are allowed to reach an age of 6 months to improve bone
quality (young puppies have very soft bone). It is important to
realize that some patients are candidates at age 6 or 7 months,
but may not be at age 9 or 10 months due to the advancement of
the dysplastic process. In general, surgery should be performed
as early as possible.
HOW DO WE GET STARTED?
Schedule an appointment for a consultation and examination of
your dog. If available, bring radiographs and copies of recent
lab work performed by your veterinarian. A referral to Gulf
Coast Veterinary Surgery, Orthopedics & Neurology from your veterinarian is required. It
is important that the skin is healthy before surgery. If
superficial skin infection is present, treatment may be required
before surgery can be performed.Your surgeon will perform a complete orthopedic and
neurologic evaluation to confirm the diagnosis and to make sure
other less common conditions are not present. Radiographs (if
available) will be reviewed. We maintain a complete inventory of
left and right TPO plates in all available degrees of rotation
so the hip evaluation and surgery can be performed during the
same anesthetic procedure if desired or required. General
anesthesia is required, so food should be withheld for 12 hours
prior to the appointment.
The Specialists at Gulf Coast Veterinary Surgery, Orthopedics
& Neurology are available to
consult with your veterinarian.
Please call if you have any questions:
Phone: 713-693-1122
Fax: 713- 693-1110
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