Surgical Positioning Techniques for Canine Hip Dysplasia

January 22, 2025

Hip dysplasia is a common hereditary condition in dogs, especially in certain breeds predisposed to developing it due to genetics, size, and body structure. Early diagnosis and management—including weight control, joint supplements, exercise, and sometimes surgery—can help manage the condition in affected breeds.

Risk Factors:

Genetics: Hip dysplasia is inherited, and breeding practices play a significant role in its prevalence.
Body Size: Larger dogs are more likely to develop hip dysplasia due to the strain their weight places on their joints.
Rapid Growth: Dogs that grow quickly during early life, particularly larger breeds, are at a higher risk.
Obesity: Overweight dogs experience increased pressure on their hips, which can exacerbate the condition.

Surgical Positioning Protocol

1. Pre-Surgical Preparation

Anesthesia: Ensure anesthesia is supplemented with adequate analgesia for postoperative pain control. Pre-anesthetic medications, induction, and maintenance protocols should align with the animal’s health status.
Positioning and Safety:
- Place the animal on the operating table with safety measures like padding to avoid pressure sores or nerve damage.
- Use a vacuum-activated positioner, such as the HUG-U-VAC, which conforms to the animal’s anatomy to prevent pressure sores.

2. Surgical Positioning for Common Procedures

a. Femoral Head and Neck Excision (FHO)

Position: Lateral recumbency (dog lying on its unaffected side).
Positioning Details:
- Affected leg should face upward.
- Non-affected leg may be slightly flexed to help stabilize the position.
- Extend the affected leg caudally and slightly abduct it for joint accessibility.
Support: Provide adequate support for the animal’s head and neck to avoid pressure damage.
Breathing and Circulation: Ensure the airway is patent and circulation is uncompromised.

b. Total Hip Replacement (THR)

Position: Dorsal recumbency.
Positioning Details:
- Pelvis should be symmetrically positioned for accurate joint alignment.
- Affected leg should remain extended in a neutral position.
- Contralateral leg should be securely flexed slightly for stability.
Support: Use a padded headrest and support for the thorax and abdomen to prevent stress and ensure lateral stability.

c. Triple Pelvic Osteotomy (TPO)

Position: Dorsal recumbency.
Positioning Details:
- Pelvis should be symmetrical on the table for access to all three osteotomy sites.
- Affected leg should remain extended, with the opposite leg flexed for balance.
Support: Secure the body to avoid excessive movement during the procedure.

3. General Positioning Considerations

Padding: Use padding on bony prominences (e.g., iliac crests, scapulae, and elbows) to prevent pressure sores.
Ventilation and Circulation: Ensure the position allows for chest and abdominal expansion to prevent compromised breathing and circulation.
Sterility: Maintain sterile draping and cover non-surgical areas to reduce infection risk.
Assistance: Have assistants help stabilize the patient during adjustments.

4. Post-Surgical Positioning

Monitoring: Closely monitor for complications like joint dislocation (THR) or infection.
Comfort: Ensure post-operative positioning reduces stress on the surgical site and enhances patient comfort.
Analgesia: Provide adequate IV or regional analgesia for pain control.

HUG-U-VAC Positioners

HUG-U-VAC positioners conform to the unique anatomy of each patient and are adaptable for any procedure. They offer soft-tissue friendliness, adaptability, stability, and clinical efficiency.