DPO / TPO – Hip Dysplasia Surgery

DPO (Double Pelvic Osteotomy) and TPO (Triple Pelvic Osteotomy) are surgical methods for hip dysplasia in which pelvic bones are cut and repositioned to rotate the acetabulum over the femoral head.

Which dogs are suitable for DPO and TPO?

Dogs between 4.5 and 9 months of age are considered suitable for DPO; the American College of Veterinary Surgeons (ACVS) cites a rule of thumb of under 8 to 10 months of age. The prerequisite is that the hip joints show no or only minimal signs of arthritis; what matters here is not age alone, but the measured joint laxity. The femoral head must be round and undamaged. For older dogs or advanced joint damage, veterinary surgeons usually opt for a total hip replacement (THR).

How do DPO and TPO differ?

In DPO, two bones are cut: the ilium and the pubis. The ischium is deliberately left intact, which makes the pelvis more stable and the procedure less invasive than TPO, in which the ischium is additionally cut. The acetabulum is rotated using plates of 20, 25 or 30 degrees; the actual rotation achieved is less than the plate angle and averages 15 to 23 degrees. A greater rotation brings no benefit: the 40-degree approach used in the early days was abandoned because it led to impingement on the femoral neck.

How much does a DPO or TPO cost?

A unilateral DPO costs between 2,500 and 3,500 euros, a TPO between 3,000 and 4,500 euros. For bilateral surgery, the costs double. Follow-up examinations and physiotherapy add another 500–800 euros.

How successful are these operations?

In a prospective follow-up study of 34 dogs after triple pelvic osteotomy (TPO), 87 per cent received a rating of good or excellent at the veterinary examination; in everyday life at home, assessed by the owners, it was 76 per cent (Rasmussen 1998). Arthritis still progresses: in around 40 per cent of dogs, it increased further on X-rays. The earlier the operation is performed, the less arthritis develops later; in the same follow-up study, age had no measurable effect on clinical hip function.

What happens after the operation?

The first six weeks require strict crate rest, with only short walks on a lead. Physiotherapy begins in week three with passive movements. The leg is loaded early: most dogs stand and walk again 8 to 18 hours after the operation. After about two months, the bone cuts are usually healed; free running and sport are usually permitted by the practice after X-ray control at three to four months.

What complications can occur?

The sciatic nerve runs close to the surgical site. In the largest evaluated series of 458 procedures, it was injured in 0.4 per cent of cases; transient nerve deficits occurred in another study in 3.7 per cent and resolved spontaneously within three to four weeks. Deep infections are rare, with one suspected case in the same large series, i.e. 0.2 per cent; superficial wound infections occur in around 3 per cent. Implant loosening can occur with inadequate aftercare.