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Pubic Symphysiodesis

Description

Pubic symphysiodesis (PS) is a relatively simple surgical procedure that can be performed on selected immature puppies that are at high risk for development of hip dysplasia. PS is the surgical fusion of the pubic symphysis, which in turn alters the growth of the pubic bone and changes the angle and position of the hip sockets. This can improve coverage of the femoral heads and decrease hip laxity as the puppy develops, thereby preventing the cartilage damage that leads to arthritis with hip dysplasia.

Indications

The difficulty in the PS procedure is identifying puppies that would be candidates at the appropriate age for the surgery. To be effective, PS must be performed between 14 and 20 weeks of age. This is younger than puppies have traditionally been screened for hip dysplasia and often prior to any symptoms of pain or stiffness. A candidate for PS would be a puppy of the appropriate age, typically a breed that is higher risk for hip dysplasia, with significant laxity of the hips based on palpation by a veterinarian and radiographs. PS has the potential to avoid more invasive and costly procedures in the future, but early identification is a must.

Postoperative Care

Pain medication is generally administered for a few days following surgery, but since this is a less invasive procedure, the postop pain is minimal. Tranquilizers may be helpful to avoid too much activity during the healing period.

The puppy should be confined to a small area with only short least walks for the first 2-3 weeks following surgery. After that, moderate exercise such as walks and playing are okay, but vigorous activity such as long hikes, jogging, and jumping games are not recommended until the puppy is nearly full grown (approximately one year).

Suture removal should be scheduled for 7-10 days following surgery. Recheck x-rays should be scheduled for approximately 6 months of age, and again at 8-10 months.

Prognosis

Pubic symphysiodesis has the potential to prevent many of the crippling effects of hip dysplasia by forming a tighter hip as the puppy grows. In severe cases of hip dysplasia, PS  alone may not be sufficient to give the best possible function, and additional surgeries such triple pelvic osteotomy (TPO), total hip replacement (THR), or femoral head and neck ostectomy (FHO) may still be indicated once the dog is older.

Your pet’s recovery and well-being are our primary concerns, so please do not hesitate to call and speak with a surgical technician or surgeon if there are any questions regarding your pet’s recovery.

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