When is Total Hip Replacement Needed for Dogs, and What Is the Recovery Like?

JointQ&AMeongsiljang Veterinary Advisory Board

We’ve put together a practical guide for owners of dogs with end-stage hip dysplasia, covering everything from candidates for total hip replacement, the surgical procedure, recovery time, and success rates, to how it differs from femoral head ostectomy.

What Is Total Hip Replacement?

A veterinarian explaining a dog's hip X-ray to its owner.

Total Hip Replacement (THR) is an orthopedic surgery that completely replaces the damaged bones and cartilage of a dog’s hip joint with metal and polyethylene artificial implants, enabling the dog to walk without pain. The most critical factor is finding a board-certified veterinary surgeon with extensive experience. THR is a highly complex procedure that only a select few specialists with the necessary skills, experience, and facilities can perform. When successfully executed, many dogs regain an activity level nearly identical to normal, earning the procedure a reputation as “highly successful” in veterinary medicine. If your dog has end-stage hip dysplasia or pain that cannot be managed with medication, please consult with a specialist.

Which Dogs Need This Surgery?

Total hip replacement is reserved for end-stage joint disease when pain cannot be adequately managed with medication and rehabilitation. It is not indicated for every hip problem. - End-stage hip dysplasia: Severe lameness due to bone deformity and osteoarthritis - Chronic hip luxation: Loss of joint function from recurrent dislocation - Avascular necrosis of the femoral head (Legg-Calvé-Perthes disease): Interruption of blood supply to the femoral head in young small-breed dogs, leading to bone necrosis and resorption - Post-traumatic joint destruction: Irreparable damage to the articular surface following fracture The timing of surgery is determined by a veterinary surgical specialist based on a comprehensive assessment of skeletal maturity, body weight, and overall health. Although cases have been reported using cementless prostheses in skeletally immature patients, individual clinical condition is a more critical determinant than chronological age.

How Does It Differ From Femoral Head Ostectomy (FHO)?

There are two main surgical options for hip pain. The choice depends on your pet’s weight and activity level. Please review the comparison chart below first.

Total Hip Replacement vs. Femoral Head Ostectomy Comparison

Item	Total hip replacement	Femoral head ostectomy
Restoration of joint function	Near-normal level	Formation of a false joint (pseudoarthrosis)
Suitable body weight	Mainly medium and large dogs	Mainly small and lightweight dogs
Surgical difficulty	Very high	Moderate
Recovery period	3–6 months	6–12 weeks
Success rate	High when performed by an experienced specialist	Good in small, lightweight dogs
Need for rehabilitation	Essential	Essential

The correct choice requires a veterinary surgical specialist's judgment based on body weight, age, and joint condition.

How Is the Surgery Performed?

The procedure takes about 2 to 3 hours under general anesthesia. The surgical steps are as follows: 1. Approach: An incision is made on the side of the hip to expose the hip joint. 2. Removal of the femoral head: The damaged femoral head and cartilage are excised. 3. Preparation of the acetabulum (pelvic side): The space is prepared for insertion of the artificial cup (acetabular cup). 4. Insertion of the femoral stem: A metal stem is secured inside the femur. 5. Attachment of the artificial ball: A metal or ceramic head is mounted onto the femoral stem. 6. Joint reduction and closure The implant is fixed either with bone cement or using a cementless technique that allows the bone to grow naturally into the implant.

Cross-sectional illustration of the components of a canine artificial hip implant

Complication Risks to Check Before Surgery

Although rare, there are some complications you should be aware of. The most common include infection, dislocation, implant loosening, femoral fracture, and sciatic nerve damage. The risk of complications depends on the surgical team’s experience, as well as the patient’s weight, age, and overall health, so it’s important to discuss individual risks with your veterinarian. Before surgery, blood tests and cardiac evaluations are performed to assess anesthesia risk, and preventive antibiotics are administered to reduce the chance of surgical site infection. Your veterinarian will explain the specific risks based on your pet’s weight, age, and overall condition. If both hips require surgery, it is generally recommended to wait until one side has fully recovered before proceeding with the other.

Post-Operative Recovery and Rehabilitation

Half of the success of surgery depends on post-operative care. Here are the key points for each stage of recovery: - 1–2 weeks: Strict cage rest, allowing only short bathroom walks - 2–6 weeks: Gradually increase leash walks starting from 5–10 minutes; avoid slippery floors - 6–12 weeks: Begin rehabilitation with underwater treadmill and balance training - 3–6 months: Remove restrictions on jumping and running; check implant status with X-rays Light activities such as leash walks and swimming can aid recovery and maintain joint range of motion from right after surgery, but high-impact activities like running and jumping should be restricted until full recovery is achieved. Be especially cautious of sudden jumps or stair climbing, as these can be major causes of dislocation. For more information, please also check out Dog Joint Health Care Tips.

A puppy recovering from surgery takes a slow indoor walk with its owner.

How to Choose a Hospital and Understand Costs

Total joint replacement is a highly complex procedure that requires specialized implant sets and a skilled surgical team, making the selection criteria crucial. - Board-certified veterinary surgeon: Verify experience in orthopedic subspecialty training. - Surgical equipment: The clinic should have a dedicated implant system and a C-arm (mobile X-ray unit). - Rehabilitation support: Clinics offering access to underwater treadmills and physical therapy are advantageous. - Post-operative care: Choose a clinic that provides long-term follow-up examinations at one and three years. Asking about the number of surgical cases performed is the most reliable way to assess experience. Since costs vary significantly between clinics and unverified price information can be misleading, always request a direct consultation for an accurate estimate.

Reviewed by a veterinarian

Dr. Tony — Punnawat Phongkittirak

Veterinarian

A veterinarian who majored in veterinary medicine at Khon Kaen University, Thailand, and completed the IVSA program at North Carolina State University in the United States. Drawing on clinical experience at animal hospitals, he works in the pet healthcare field and is dedicated to building a digital care environment that connects pet parents with veterinarians.

Frequently Asked Questions

Will my pet be able to run around like before after surgery?

After a successful surgery and rehabilitation, many dogs recover to near-normal activity levels. However, it’s best to avoid intense jumping and high-impact sports for the rest of their lives.

Up to what age can a pet undergo surgery?

There’s no upper age limit. What matters more is whether your pet’s overall health and heart and kidney function are strong enough to withstand anesthesia. Pets aged 8 to 10 years or older can still undergo surgery if they’re healthy.

Do artificial joints last a lifetime?

Implants are designed to maintain their function over the long term. Proper weight management and avoiding excessive impact can help extend their lifespan. Regular X-rays are important to consistently monitor for any signs of implant loosening.

Is it possible to operate on both hips at the same time?

Typically, we perform the surgery on one side at a time. This is because having one healthy side is essential for supporting the animal's weight after the opposite side has been operated on.

Is there any alternative to surgery?

In the early to moderate stages, we can manage the condition with weight loss, rehabilitation, cartilage supplements, and pain relievers. However, if medication isn’t enough to control the pain, it’s time to discuss surgery.