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How to Know If Your Dog Is a Candidate for Total Hip Replacement

How to Know If Your Dog Is a Candidate for Total Hip Replacement

Total Hip Replacement

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Owners

Find out the key health, age, and breed factors that determine if your dog is a candidate for total hip replacement surgery

By 

Sustainable Vet Group

Updated on

August 19, 2025

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How to Know If Your Dog Is a Candidate for Total Hip Replacement

What Is Total Hip Replacement in Dogs?

Total hip replacement (THR) in dogs is a surgical procedure where the damaged ball and socket of the hip joint are removed and replaced with prosthetic implants. The ball is replaced with a metal or ceramic head, while the socket is fitted with a strong plastic or metal cup. These implants work together like a natural hip joint, allowing smooth and pain-free movement.

The main goal of THR is to restore mobility and eliminate the chronic pain caused by severe hip conditions, such as hip dysplasia or arthritis. With a successful replacement, dogs can return to normal activities like walking, running, or climbing stairs. It is considered the gold-standard treatment when other therapies no longer provide relief.

General Health Requirements

For a dog to qualify for total hip replacement, general health must be stable. Surgery is demanding, and the body should be able to handle anesthesia, healing, and rehabilitation. Any underlying illness or untreated infection increases risks and can compromise the outcome.

  • Dogs must be free from serious systemic illness, including heart, liver, or kidney disease
  • Active infections such as skin wounds, dental disease, or urinary tract infections must be treated first
  • A healthy body weight is essential — obesity increases joint stress, while malnourishment slows healing
  • Good overall condition helps reduce surgical complications and improves recovery quality

Ensuring medical stability before surgery gives the implants the best chance to succeed. A healthy patient is far more likely to enjoy long-term mobility and pain relief.

Age and Growth Considerations

Skeletal maturity is an important factor in deciding if a dog is ready for hip replacement. The implants must be placed in a fully developed bone structure to stay secure over time. Puppies with open growth plates cannot undergo this procedure, as their hips are still changing.

  • Dogs should be skeletally mature, typically 9–12 months of age
  • Giant breeds may take longer to reach full maturity and often need additional time
  • Puppies with open growth plates are not eligible, as growth can loosen implants
  • Senior dogs may still qualify if they are otherwise healthy and have no major systemic issues

Evaluating age alongside health ensures implants remain stable and effective. With the right timing, both young adults and seniors can benefit greatly.

Size and Breed Suitability

Total hip replacement was once limited to medium or large dogs due to implant design. In recent years, technology has advanced, making the procedure possible for dogs of nearly all sizes. Today, both toy breeds and giant breeds can undergo hip replacement safely if they meet the other health requirements.

  • Historically, candidates had to weigh at least 30–40 pounds for implant stability
  • Modern implants are available for very small dogs, as light as 5 pounds
  • Giant breeds weighing up to 170 pounds can also receive custom implants
  • Breeds often affected include Labradors, German Shepherds, Golden Retrievers, and Rottweilers
  • Smaller breeds like Pugs and Chihuahuas can now also be considered if hip disease is severe

Advances in veterinary orthopedics mean size is no longer a strict limitation. With proper implant selection, almost any dog can be a candidate for hip replacement.

Hip Conditions That Indicate THR

Total hip replacement is usually recommended only when hip disease is advanced and other treatments no longer control the pain. This surgery addresses the root cause of joint dysfunction rather than just easing symptoms.

  • Severe hip dysplasia causing chronic pain and mobility loss
  • Advanced osteoarthritis not improved with medication or therapy
  • Repeated hip luxation or chronic dislocation
  • Fractures of the hip joint or avascular necrosis of the femoral head
  • Failure of conservative care such as NSAIDs, supplements, or weight management

When these conditions lead to constant pain and reduced quality of life, hip replacement becomes the most effective solution. It restores joint function, reduces suffering, and allows dogs to regain normal movement.

Orthopedic and Neurologic Exclusions

Not every dog with hip disease is a good candidate for total hip replacement. Certain orthopedic or neurologic problems may interfere with surgery or limit the outcome. If other joints or the nervous system are compromised, even a new hip will not restore proper mobility. Careful evaluation is essential before making the decision.

  • Severe arthritis in other joints such as the knees, elbows, or spine can limit recovery
  • Neurologic disease, including spinal cord injury, nerve damage, or poor limb control, prevents proper function of the new joint
  • Dogs with severe lameness due to nerve deficits cannot benefit fully from hip replacement
  • A history of femoral head ostectomy (FHO) surgery reduces bone quality, lowering the chances of implant stability and long-term success
  • Comprehensive orthopedic and neurologic exams, often including imaging, help identify hidden risks

Excluding dogs with these conditions protects them from unnecessary surgery and disappointment. A hip replacement must be placed in a body capable of supporting and using the implant.

Temperament and Behavior Factors

Behavior and temperament are often overlooked but play a major role in total hip replacement success. Recovery requires strict rest, controlled activity, and cooperation with aftercare. A dog that cannot tolerate these restrictions may face complications, even if the surgery itself goes well.

  • Dogs must tolerate crate rest for several weeks to protect the new joint
  • Leash-only walks are necessary during early recovery, limiting free activity
  • Regular follow-up visits, including X-rays, are required to monitor healing
  • Aggressive dogs may resist handling, making wound care and exams unsafe
  • Highly anxious dogs may injure themselves by fighting against restrictions or chewing at the incision site
  • Calm, cooperative temperaments adapt best to recovery routines and achieve stronger outcomes

A successful hip replacement depends on both the surgery and the dog’s ability to recover safely. When the patient cooperates, healing is smoother, and the chances of long-term mobility are much higher.

Veterinary Evaluation Process

Before a total hip replacement can be scheduled, your dog must undergo a detailed veterinary evaluation. This process helps confirm that surgery is safe, suitable, and likely to succeed.

  • Physical Examination – A full body check ensures there are no hidden health issues that could complicate anesthesia or healing.
  • Orthopedic and Neurologic Exams – These tests confirm that hip disease is the main cause of pain, ruling out problems in the spine, knees, or nerves.
  • Imaging and X-rays – Detailed hip images show the level of damage, bone structure, and the exact implant size required for long-term stability.
  • Blood Tests and Urinalysis – These screenings confirm healthy kidney, liver, and heart function, which are essential for anesthesia and recovery.
  • Final Orthopedic Surgeon Review – A board-certified surgeon reviews all results to make the final call on surgery candidacy.

This multi-step process ensures no detail is missed. With careful evaluation, the chosen treatment is tailored to the dog’s condition, improving safety and long-term outcomes.

Bilateral vs Unilateral Hip Replacement

When both hips are diseased, surgeons must decide whether to replace one or both. Each approach has unique benefits and challenges, and the decision depends on the severity of disease and recovery expectations.

  • Unilateral Replacement – Often only one hip needs surgery, especially if it is clearly more painful. Many dogs achieve near-normal function this way.
  • Functional Compensation – Dogs can often balance well with one healthy hip, regaining mobility without immediate surgery on the second joint.
  • Bilateral Hip Disease – In cases where both hips are severely affected, staged replacement may be considered for full pain relief.
  • Staged Surgeries – If both hips need replacement, the second procedure is usually performed 3–6 months later to allow healing between surgeries.
  • Single-Stage Bilateral Surgery – Rarely done, as it increases risks, stress, and recovery time, making staged procedures the safer choice.

For most dogs, replacing one hip is enough to restore quality of life. If needed, a second surgery later ensures comfort and stability without overwhelming recovery.

Owner Commitment and Post-Op Care

Total hip replacement does not end when the surgery is complete. The success of the procedure relies heavily on how well the owner follows post-operative care instructions. A strong commitment to recovery routines is one of the most important factors in ensuring long-term results.

  • Strict Confinement – Dogs must stay in controlled environments for 8–12 weeks after surgery. This includes crate rest and limited movement to protect the new implant.
  • Restricted Activity – Only short, leash-controlled walks are allowed during the early stages of recovery. Running, jumping, or free play can lead to complications.
  • Follow-Up Visits – Multiple recheck appointments, often including X-rays, are required to confirm healing and check implant stability. Skipping these visits can delay detection of problems.
  • Long-Term Lifestyle – Weight control, a balanced diet, and joint-friendly habits such as low-impact exercise are essential to protect the replaced hip.
  • Owner Responsibility – The surgeon provides the implants, but daily care depends on the owner’s dedication to the recovery plan.

When owners commit fully to post-op care, their dogs are far more likely to return to a pain-free, active lifestyle after hip replacement.

Conclusion

Total hip replacement (THR) is the gold-standard solution for dogs with severe hip disease, offering lasting pain relief and restored mobility. For many patients, it means the chance to walk, run, and play again without constant discomfort.

However, not every dog is a candidate for this surgery. Strict criteria related to age, health, temperament, and orthopedic condition must be met before moving forward. Careful screening protects the dog’s safety and ensures the best possible outcome.

The final decision always rests with a veterinary orthopedic surgeon. Through detailed exams and imaging, the surgeon can confirm if THR is truly the right option. When selected carefully, this surgery gives dogs a renewed quality of life and a healthier, more active future.

FAQs

How do I know if my dog is a candidate for total hip replacement?

A dog is a candidate if it has severe hip pain from dysplasia or arthritis, is skeletally mature, in good health, and free of infections. The final decision is made by a veterinary orthopedic surgeon after exams, imaging, and blood tests to ensure the procedure will be safe and effective.

Can small or toy breed dogs have hip replacement surgery?

Yes, advances in implant design now allow hip replacement in dogs as small as 5 pounds. Historically limited to larger breeds, the procedure is now possible for both toy breeds and giant breeds. The surgeon will choose an implant size that fits your dog’s anatomy, making surgery safe across all sizes.

What age is too young or too old for hip replacement in dogs?

Dogs must be skeletally mature, usually 9–12 months for most breeds, and later for giant breeds. Very young puppies cannot undergo the surgery. Senior dogs are not automatically excluded; many older patients qualify if they are otherwise healthy. The surgeon evaluates both age and overall health before deciding if surgery is suitable.

How long is the recovery period after total hip replacement?

Recovery typically takes 8–12 weeks. During this time, dogs must remain on crate rest with only short, leash-controlled walks. Multiple recheck visits with X-rays are needed to confirm healing. Once cleared by the surgeon, gradual return to normal activity is allowed. Long-term care, including weight management, protects the new joint.

Can both hips be replaced at the same time?

Most dogs only need one hip replaced to regain mobility. If both hips are severely affected, surgeons usually perform staged surgeries, 3–6 months apart, to reduce risks and aid recovery. Replacing both hips in a single surgery is rare, as it increases complications and makes rehabilitation much more difficult.

What are the risks of total hip replacement in dogs?

Like any major surgery, hip replacement carries risks such as infection, implant loosening, or complications from anesthesia. Dogs with other orthopedic or neurologic issues may not recover well. Strict post-operative care is critical to minimize problems. With proper screening and aftercare, most dogs achieve excellent long-term outcomes and pain relief.

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