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Dictionary of Terms
Triple Pelvic Osteotomy Surgery
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What is a Triple Pelvic Osteotomy surgery?
by Dr. N.J.Hayes, DVM
Hip dysplasia is a common ailment of large and small breed dogs. It typically is seen in the larger breeds such as retrievers, Rottweilers, newfoundlands, and other large breeds. It can often be seen in smaller dog such as cocker spaniels, Sheba inus, and other medium sized breeds. In large breeds such as the Labrador retriever, it is not uncommon for this disease to become crippling, causing pain and discomfort as the dog is moving or trying to get up.
Fortunately, there are several surgeries available for hip dysplasia. If medication is tried and is not helping enough, surgery can be considered. These surgeries include FHO (femoral head ostectomy), TPO (triple pelvic osteotomy), and total hip replacement.
In this article we will discuss the TPO. The TPO, Triple Pelvic Osteotomy, is commonly used in young dogs. Because hip sockets will fill in with bone over time, the ideal age for this surgery is less than a year. In dogs over a year of age the sockets may be too filled in for this procedure to be beneficial.
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The TPO is essentially a reconstruction of the pelvis which allows for rotating the femoral head deeper into the socket (acetabulum). If your dog is diagnosed with hip dysplasia with radiographs, (please see hip dysplasia handout), this is one of the procedures that will be discussed with you.
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The term triple pelvic osteotomy comes from the fact that there are three cuts in the pelvis. A cut in the bone is called an osteotomy. Let’s look at the hip x-ray of a dysplastic dog.
In the x-ray you can see that the ball of the femur (leg) is sticking out farther than the depth of the socket. The depth of the socket is OK in this dog which makes it a candidate for a TPO.
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| Hip x-Rays of Dysplastic Dog |
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In the drawing shown you can see where the cuts will be made. This drawing is taken from the procedure manual for the Slocum TPO, the inventor.
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| For larger view, click on above picture. |
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This is a model of a pelvis with the cuts diagramed in black. This model shows the legs and also a bit of spine so that you can see the relationship to each other. Once the cuts are made the pelvis can be rotated and then the plate is applied to secure the bones back together.
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| A pelvis model that shows the proposed cuts. |
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After it has healed, the pelvis is normal.
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| A healed Pelvic bone. |
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Let’s meet Jake. He is a Labrador retriever who is eight months old. Jake has been demonstrating difficulty getting up off the floor and some occasional lameness in his rear.
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| Jake, the Labrador Retriever. |
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After Jake is anesthetized, some x-rays are taken to determine if he has hip dysplasia or not. (Actually, Jake’s x-rays were taken well before the surgical day so that the owners had time to hear - and think about, their options.) After Jake’s x-rays were taken that day, the owners elected to give Jake a triple pelvic osteotomy. This will allow Jake to live the most normal of lives. On the day of surgery, Jake gets what’s called a frog leg x-ray.
This x-ray allows us to see how deep the sockets are, and whether not the surgery would actually benefit Jake.
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| Because Jake is an excellent candidate for the TPO, he was prepared for surgery. |
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This surgery requires a great deal of shaving to be sure that the fur is completely away from incision sites. (to prevent the infection).After Jake has been properly scrubbed and prepared for surgery, he will be moved into the surgery suite.
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| Jake is carefully shaved and scrubbed. |
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Anesthesia is an inhalant anesthetic coupled with some injectable pain relievers. Because of the length of this procedure and a concern for discomfort, intravenous pain medication is delivered continuously before, during, and after the procedure. This ensures that the greatest possible comfort level can be delivered.
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| A technician will constantly monitor the anesthesia for this procedure. |
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This surgery will require two doctors, a technician to constantly monitor the anesthesia, and a technical scrub nurse. Her job is to assist the doctors in keeping the instruments organized and handling extra instrumentation. Another technician will be standing by, in case other sterilized supplies are needed.
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| A technical scrub nurse is required for this procedure. |
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Doctor Whitney and Doctor Hayes will both scrub in on Jake's surgery. Because the surgery is so technically demanding, it is important to have two doctors available.
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| Dr. Whitney and Dr. Hayes will both be needed for Jake's surgery. |
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Because each patient is different, which medication and or surgery protocol is best for your pet will be decided individually with the help of your veterinarian. We will be happy to explain all of your options for your pet. If you have any questions, please call
309-685-4707
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The following link will open a Frames page that will allow you to read about a TPO Surgery and view actual photographs of the surgery. Please be aware that these photographs may disturb some viewers. Viewer discretion is advised.
TPO Surgery |
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References:
- Tilley, LP, Smith, FWK, The 5 Minute Veterinary Consult, Canine and Feline. 1997, Williams & Wilkins.
- Evans & Christensen, Miller's Anatomy of the Dog, 1979, W.B. Saunders Company
- Encyclopedia of Canine Veterinary Medical Information
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