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Alternatives to Hip Replacement Surgery in Large Dogs

Alternatives to Hip Replacement Surgery in Large Dogs

Total Hip Replacement

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Explore effective alternatives to hip replacement surgery in large dogs, including surgical options, non-surgical care, regenerative therapies, and long-term outcomes

By 

Sustainable Vet Group

Updated on

August 19, 2025

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Alternatives to Hip Replacement Surgery in Large Dogs

Why Look for Alternatives to Hip Replacement in Large Dogs?

Total hip replacement (THR) is considered the gold standard for treating severe hip disease, but it may not be the right choice for every dog. Large breeds, in particular, require careful consideration because of their size, weight, and the demands placed on their joints.

  • High Cost of Surgery – THR often ranges from $4,000 to $10,000 per hip, which may be unaffordable for some owners.
  • Age and Health Concerns – Senior dogs or those with systemic illnesses may face higher surgical risks and longer recovery times.
  • Owner Preference – Some families prefer less invasive options, especially when managing comfort rather than pursuing full joint restoration.
  • Unique Large-Breed Challenges – Heavier dogs place more stress on implants, increasing the importance of evaluating alternatives that can still reduce pain and improve mobility.

Considering alternatives ensures that every dog receives the most practical and safe solution for its individual needs.

Surgical Alternatives to Hip Replacement

While THR is the most effective treatment, certain surgical alternatives may provide relief when hip replacement is not possible. These procedures are usually chosen based on the dog’s age, size, and stage of hip disease.

1. Femoral Head Ostectomy (FHO) in Large Dogs

FHO involves removing the femoral head, which allows a false joint to form. It can relieve pain by stopping bone-on-bone contact, but in large breeds, outcomes are less predictable because body weight and muscle mass place more stress on the joint.

Many large dogs develop an abnormal gait or limited strength post-FHO. Still, it may be useful when THR is not affordable or possible, especially in cases of severe fractures or chronic dislocations where pain relief is the priority over restoring full mobility.

2. Triple or Double Pelvic Osteotomy (TPO/DPO)

TPO and DPO surgeries involve cutting and rotating sections of the pelvis to improve coverage of the femoral head. These procedures are designed for younger dogs—typically under one year—who show early signs of hip dysplasia but have not yet developed arthritis.

When performed at the right stage, TPO/DPO can help preserve the natural hip joint and delay the need for more advanced surgeries. However, once arthritis sets in, results are poor. Large breed dogs diagnosed early may benefit, but the strict age and condition requirements limit its use.

3. Juvenile Pubic Symphysiodesis (JPS)

JPS is a preventive surgery done in puppies younger than 5 months. It works by altering the growth of the pelvis so the hip socket develops better coverage of the femoral head. This reduces the chance of severe hip dysplasia later in life.

However, timing is critical—if the puppy is older or already showing signs of arthritis, JPS is no longer effective. In large dogs, JPS is rarely used once hip disease is established, but it may help breeders or owners of high-risk puppies by reducing future problems.

Non-Surgical Alternatives for Large Dogs

When hip replacement is not an option, non-surgical approaches can still improve comfort and mobility in large dogs. These methods focus on managing pain, protecting joints, and supporting long-term quality of life.

1. Weight Management and Exercise Control

Excess weight puts enormous strain on already weak hips, especially in large dogs. Careful weight management through calorie-controlled diets is one of the most effective ways to reduce pain. Controlled, low-impact exercise such as leash walking and swimming keeps joints flexible without overloading them.

Activities like running, jumping, or rough play should be avoided. Consistency is key, as even moderate weight loss can significantly reduce hip stress. With proper exercise control, large dogs maintain strength while avoiding activities that accelerate joint degeneration.

2. Pain Management and Medications

Medications are often essential for long-term comfort in large dogs with hip disease. Non-steroidal anti-inflammatory drugs (NSAIDs) help reduce both pain and inflammation.

Additional medications like gabapentin or tramadol may be used for nerve or breakthrough pain. Joint supplements containing glucosamine, chondroitin, and omega-3s support joint health and reduce stiffness.

These treatments do not cure hip disease but provide meaningful relief and improve daily function. Long-term veterinary monitoring is needed to adjust dosages and minimize potential side effects.

3. Physical Therapy and Hydrotherapy

Physical therapy builds strength in the muscles surrounding the hip, providing extra stability to weakened joints. Exercises like controlled sit-to-stand routines, gentle stretching, and balance training can improve mobility.

Hydrotherapy, including swimming and underwater treadmill sessions, allows dogs to exercise without putting weight on painful joints. These methods increase circulation, reduce stiffness, and improve confidence in movement.

Structured rehabilitation under professional guidance can extend mobility and significantly improve quality of life. For many large dogs, consistent physiotherapy delays the need for surgery and provides safer long-term management.

Regenerative and Advanced Therapies

Regenerative medicine is increasingly being explored as an alternative for managing hip disease in large dogs. These advanced therapies focus on reducing pain and promoting healing within the joint.

  • Stem Cell Therapy – Mesenchymal stem cells, often harvested from fat or bone marrow, are injected into the hip joint to reduce inflammation and encourage tissue repair. Some dogs show improved comfort and mobility, though results can be variable.
  • Platelet-Rich Plasma (PRP) – PRP injections deliver concentrated growth factors that help decrease inflammation and promote healing. These can be combined with other treatments for better results.
  • Prolotherapy – Involves injecting irritant solutions around ligaments to stimulate new tissue growth, potentially increasing joint stability.
  • Limitations in Large Dogs – While promising, these therapies often provide partial improvement and may not restore full function, especially in heavier breeds.

Regenerative therapies can reduce pain and delay surgery but are rarely permanent solutions. For large dogs, they are best considered as part of a broader treatment plan.

Supportive Devices and Lifestyle Adjustments

Supportive devices and home adjustments play a major role in improving comfort and independence for large dogs with hip disease. These simple interventions protect joints and make daily living safer.

  • Hip Braces and Harnesses – Braces stabilize the hip joint and reduce pain during movement. Harnesses give owners better control when assisting dogs with walking or climbing.
  • Orthopedic Beds – Provide cushioning and joint support, reducing stiffness after rest and encouraging proper posture.
  • Ramps and Stairs Alternatives – Installing ramps for vehicles, furniture, or outdoor steps prevents jumping, which can worsen hip pain.
  • Non-Slip Flooring – Mats or rugs prevent slipping on tile or hardwood, reducing the risk of falls.
  • Owner’s Role – Monitoring activity, creating a safe space, and maintaining routine adjustments are vital for long-term success.

With the right support devices and home care, many large dogs can remain active and comfortable despite hip disease.

Combination Approaches for Better Outcomes

No single alternative can fully match the success of hip replacement, especially in large dogs. However, combining multiple strategies often leads to better long-term results and improved quality of life.

  • Braces Plus Weight Control – Using hip braces alongside strict weight management reduces stress on the joint and supports stability.
  • Exercise with Therapy – Low-impact exercise, combined with hydrotherapy or physiotherapy, strengthens muscles and helps compensate for joint weakness.
  • Medications with Supplements – Long-term NSAID use, supported by glucosamine, chondroitin, and omega-3s, provides layered pain control and joint support.
  • Advanced Therapies as Add-Ons – Stem cell or PRP injections can be used in combination with physical therapy to extend mobility further.
  • Setting Expectations – While these methods improve comfort, they rarely restore full athletic ability in large dogs. The goal is pain reduction and better daily function.

Multi-modal management maximizes results by addressing hip disease from several angles. With realistic expectations, dogs can enjoy meaningful improvements in quality of life.

Cost Comparison of Hip Replacement Alternatives

When total hip replacement is not possible, cost often becomes a major deciding factor in choosing alternatives. Each option carries its own expense range, depending on the procedure, follow-up care, and the dog’s size.

  • Femoral Head Ostectomy (FHO) – Typically costs $2,000–$4,500. While less expensive, results are less predictable in large dogs and may lead to gait changes.
  • Triple or Double Pelvic Osteotomy (TPO/DPO) – Priced around $3,000–$6,000. Best for younger dogs before arthritis develops, making it less commonly applicable in adults.
  • Stem Cell Therapy or PRP Injections – Range from $2,000–$5,000. Provide temporary pain relief but usually require repeat treatments.
  • Hip Braces – Cost $200–$800. Affordable and non-invasive, but they provide only partial support.
  • Conservative Management – Includes medications, supplements, and physiotherapy. While monthly costs may seem low, they accumulate significantly over a dog’s lifetime.

Though less costly upfront, many alternatives may require repeat treatments or ongoing care. Owners should balance immediate affordability with long-term outcomes.

Long-Term Expectations Without Hip Replacement

Alternatives to hip replacement can provide significant relief, but they rarely restore full hip function in large dogs. Owners should understand what outcomes are realistic.

  • Pain Reduction – Surgeries like FHO or therapies such as PRP can decrease pain, but results may not equal the stability of a prosthetic joint.
  • Mobility Improvements – Physiotherapy, hydrotherapy, and braces help maintain function, though gait abnormalities may persist in heavier dogs.
  • Limitations in Large Breeds – Because of their size, large dogs often place more stress on affected joints, making results less predictable compared to smaller breeds.
  • Importance of Early Diagnosis – Interventions like TPO or JPS are only effective when started early, before arthritis permanently damages the joint.
  • Ongoing Management – Consistent weight control, supplements, and veterinary monitoring are required for long-term comfort.

While alternatives can extend mobility and reduce suffering, they cannot fully replicate hip replacement. Realistic goals focus on comfort, daily function, and slowing disease progression.

Conclusion

Total hip replacement (THR) remains the gold standard for treating severe hip disease, offering the best chance for restoring full mobility and long-term comfort. However, it is not always possible for every large dog due to cost, health, or owner preference. In such cases, alternatives like FHO, TPO/DPO, regenerative therapies, and conservative management can still provide meaningful relief.

Large dogs benefit most from tailored solutions that combine surgery, rehabilitation, weight management, and supportive lifestyle adjustments. While these options may not match the complete outcomes of THR, they can extend mobility, reduce pain, and improve quality of life.

The final step should always be consulting a veterinary orthopedic specialist. With expert guidance, owners can make the safest, most effective choice for their dog’s unique needs.

FAQs

What are the main alternatives to hip replacement in large dogs?

Alternatives include femoral head ostectomy (FHO), triple or double pelvic osteotomy (TPO/DPO), juvenile pubic symphysiodesis (JPS), regenerative therapies like stem cells or PRP, supportive devices such as hip braces, and conservative management with medications, weight control, and physiotherapy. The best option depends on the dog’s age, size, and stage of disease.

Is femoral head ostectomy (FHO) effective for large dogs?

FHO can relieve pain by removing the femoral head, but outcomes are less predictable in large breeds due to their weight and muscle mass. Many large dogs develop an altered gait or reduced strength after FHO. It may still be considered when hip replacement is not possible, especially for pain relief.

Can younger large-breed dogs benefit from pelvic osteotomy?

Yes, triple or double pelvic osteotomy (TPO/DPO) can help younger dogs diagnosed with hip dysplasia before arthritis develops. It realigns the hip socket to improve stability. However, the procedure must be performed early, usually under one year of age, making it unsuitable for older large dogs with advanced joint damage.

How do regenerative therapies help dogs with hip disease?

Stem cell therapy, platelet-rich plasma (PRP) injections, and prolotherapy reduce inflammation, promote healing, and may improve comfort. These therapies are less invasive than surgery and can delay progression of hip disease. However, results vary, and in large dogs, they often provide partial improvement rather than restoring full mobility or joint function.

Are braces and lifestyle changes enough for large dogs with hip problems?

Braces, ramps, orthopedic bedding, and non-slip flooring can make daily life safer and more comfortable. While these adjustments do not cure hip disease, they reduce stress on joints and prevent further injury. When combined with weight control and low-impact exercise, they can significantly improve quality of life for large dogs.

How do costs of alternatives compare to hip replacement?

Alternatives are generally less expensive than total hip replacement. FHO costs $2,000–$4,500, TPO/DPO around $3,000–$6,000, and regenerative therapies $2,000–$5,000. Braces range from $200–$800, while long-term conservative care builds ongoing monthly costs. While more affordable, these options may require repeat treatments and usually don’t match the lasting results of THR.

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