Case: Hip neurectomy
29th December 2013
Hip dysplasia is common. It frequently becomes apparent from 6 months or so of age and can lead to serious pain when the hip is extended. In larger dogs at least, the gold standard surgical treatment is total hip replacement surgery (see separate article on THR). This is however is pretty expensive and does carry some risk (perhaps 5%) of significant/serious complications. There is also the need for diligent aftercare and restraint in the early post-op period to optimise outcomes.
For cases where finances are a limiting factor or where the owner doubts that they can comply with the aftercare required for a THR, or where the risk of complications of a THR puts the owner off the idea, then neurectomy is frequently an option. Neurectomy is less aggressive than femoral head and neck excision where the the ball of the ball-an-socket articulation is excised. So unlike FHNE, neurectomy avoids removing any residual mechanical support that the (abeit poor quality) hip articulation can offer.
Neurectomy involves surgically damaging the sensory innervation to the joint capsule of the affected hip(s). It doesn’t further destabilise the articulation (like a femoral head and neck excision would – see the separate article on this surgery). Neurectomies can be done on both sides at the same time and costs are much less than for THR. No special aftercare is required other than protecting the overlying soft tissue wound while it heals in the 2 weeks or so post-op. The risk of significant adverse complications with neurectomy is low. The rest of the innervation to the hindlimb(s) is intact and there is no adverse functional significance from the dog’s point of view in losing the sensation to the hip joint.
This surgery is usually done on dogs, and often on larger rather than smaller ones. We have however also performed this surgery on cats with a pleasing outcome.