JUVENILE
PUBIC SYMPHYSIODESIS (JPS)
Hip
dysplasia is a genetically transmitted disease that
results in a poorly formed hip joint. At some period
during the dog’s lifetime this abnormal hip
development gives rise to osteoarthritis and joint
degeneration. The degree of pain from osteoarthritis
may only show as stiffness and weakness in the hind
legs or the pain may totally incapacitate the individual
causing prolonged recumbency and poor quality of life.
In the dog, hip dysplasia is the most common orthopedic
problem and the most important cause of osteoarthritis.
Hip dysplasia is found in all breeds; however, large
breeds have a greater chance of showing clinical signs
due to their greater body mass.
Ideally
the socket of the pelvis should cover the entire top
aspect of the ball that extends from the femur (thigh
bone). A well-formed hip joint allows weight to be
supported by the cartilage covered bone surfaces during
all types of activity. Additionally, it is important
that the soft tissues (ligaments, joint capsule, tendons
and muscles) hold the ball tightly in the socket during
all forms of activity. Individuals with hip dysplasia
do not have good weight bearing by bone structure.
Instead, the soft tissue structures bear more weight
than they can handle, resulting in tearing and stretching
of the soft tissues. Chronic tearing and stretching
of joint structures causes painful joint inflammation
(osteoarthritis) that in turn results in the formation
of boney spurs around the joint and degeneration of
joint cartilage. When cartilage degeneration progresses
to bone on bone contact, the individual becomes incapacitated
from joint pain.
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The
clinical signs of osteoarthritis, in the form of hip
pain and stiffness, are what most people recognize
as hip dysplasia. It is important to realize that
a dog that has hip dysplasia may not display any clinical
signs of osteoarthritis. Many factors influence the
onset of osteoarthritis pain, such as: degree of dysplasia,
individual pain tolerance, activity level, body weight,
muscle development around the joint, nutrition, pain
relievers, etc. The age at which an individual begins
to outwardly show signs of hip dysplasia varies greatly.
It is very common to encounter middle-aged (4-6 years
old) dogs that are just beginning to show obvious
signs of hip osteoarthritis. Yet, when x-rays are
taken we find considerable evidence of osteoarthritis
and hip dysplasia. Therefore, the only way to diagnose
hip dysplasia in its early stages with a high degree
of certainty is through the use of radiographs (x-rays).
For
some time now, several surgical procedures have been
available to effectively treat hip dysplasia and prevent
painful osteoarthritis in fully developed adult dogs.
These surgical procedures are quite invasive, expensive
and not without possible serious complications. In
the past, there was not anything that could be done
to effectively and consistently influence the development
of the hip joints to prevent osteoarthritis in puppies
that have the genes for hip dysplasia. Now, there
is a new procedure available to help prevent the painful
symptoms of osteoarthritis caused by hip dysplasia.
The procedure is called Juvenile Pubic Symphysiodesis
(JPS). This surgical procedure is much less invasive
than the surgical treatments previously available,
and much less costly.
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Juvenile Pubic Symphysiodesis is a surgical procedure
performed that consistently and effectively inhibits
the development of osteoarthritis in individuals that
have hip dysplasia. Maximum benefit is gained if the
procedure is preformed when the puppy is 16 weeks
of age. After that, the potential benefit decreases
with each successive week until the puppy is 20 weeks
old. After 20 weeks of age the pelvis is probably
too well developed for a JPS to have significant effect
on hip joint conformation. Early detection of hip
dysplasia is the key. Most pups do not show signs
of joint pain from hip dysplasia at 16 weeks of age.
Therefore, we must rely on radiographic (x-ray) evaluation
to tell us if a JPS procedure is indicated to prevent
osteoarthritis from developing in an individual.
Juvenile Pubic Symphysiodesis involves
heating (cauterizing) an area near the center of the
lower pelvis (pubic bone). The procedure alters how
the pelvis develops. The area of the pelvis above
the hip joints grows outward and over the hip joints.
This change in the pelvic growth pattern improves
the coverage of the socket over the ball. The resulting
hip joint conformation provides improved weight bearing
by the skeleton and significantly decreases the chances
osteoarthritis will develop in the future.
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