Arthritis Post Hip Replacement

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Hi, I wanted to ask what the chances are of developing arthritis after a hip replacement and how long after the surgery it could occur?  My rescue lurcher was involved in a RTA at 10/11 months old.  Her femur smashed through the acetabulum obliterating it and fractured her pelvis in several places.
She had reconstrucive surgery at Davies Vet Hospital, but unfortunately the metal implant failed and there was malunion of the bone, so 6 months after her accident (April 2017) she had a total hip replacement (it was mentioned that quite a bit of arthritis was removed during this operation).  She suffered a sciatic nerve injury during the surgery, but with extensive rehab this eventually resolved.
She had a lot of hydro and physio at the hospital (she was under their care for a total of 15 months) and we also had a physio come to our home during that time.  We made a lot of adaptions to the house and we did massage, physio – a range of stretches and exercises, pole work etc, increasing time on lead walks, Hivamat Deep oscillation (I have a machine), nerve and muscle stimulation, hot and cold therapy, KT taping, proprioceptive techniques…. the list goes on (!) 3 x a day and she made a fantastic recovery in the end and now legs it around like a greyhound!
She is very long in the body and I know sitting is often uncomfortable for sighthounds and lurchers, so I never ask this of her, but I noticed that since the accident she is unable to sit for more than a second and that she does an odd bum shuffle to get into a down and getting back up from lying down is slightly awkward like there is a little stiffness and the muscle has never rebuilt to be the same size as the other one (although it is pretty big and strong now), you can also see it’s slightly shorter on that side than the other.
I have booked her with a Galen therapist as I think that may help her and if so, I would like to train in it myself to help her and hopefully other dogs who have chronic pain (I do human massage part time).
She suffered some behavioural issues as a result of all this and we have worked with a vet behaviourist on that front.  He did mention that she had high chances of developing arthritis, but I had so much else to take in at the time that I didn’t ask more, but I wondered whether this could be the cause of her stiffness on getting up and lying down or whether it’s too soon to be thinking that could be the cause or if is just habit from when she was in pain as it’s something she has done since her first surgery?

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Wow
You have been through it all.vwell done in your extensive rehab plan…really impressive.
If she has had a joint replacement then arthritis in the joint being the problem is not possible but post operative chronic pain could be as it is a significant concern in human joint replacement surgeries and we are concerned we are seeing the same pattern in dogs.
But you could also be seeing soft tissue discomfort as these will have also been affected during the trauma, surgery and post op period .
I feel I would go back to Davies and have a reassessment with one of their team ..they’re a thorough referral team that case share well so you’ll get an orthopaedic input neurological input, physio and chronic pain management input
XXX
We find it hard advising on supplements as the evidence so far is weak  xx

Regards
Hannah

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You’re welcome, let us know how you get on 🙂
There are a couple of CAM conversations on the website regarding supplements so have a read of those for more in depth info. Omega 3 fatty acids from a cold marine based source are the only ones with any evidence behind them shown to be beneficial. There are still debates over Glucosamine and Chondroitin, but these are thought to be most useful in the early stages of arthritis, so could be worth considering for your dog.

Lynsey

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Sorry, I also wanted to ask if there is anything we can give her as a supplement to help her?  She is on a raw diet, I also give Dorwest Easy Greens and Keepers Mix, Golden Paste and wild salmon oil.

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Thanks so much for coming back to me and that would all make sense and that’s what I initially thought about the false joint so was a bit surprised when that was suggested.  I have worried about her over compensating in other parts of her body and what effect that would have. We have booked the Galen therapist for the week after next, so I will get her thoughts and then speak to our vet about a referral back to Davies to the pain clinic.  Twiggy knows the physiotherapists there well and they will have the full history of her accident, surgery, etc on their system which helps. She is still so young and we want to ensure that she leads a comfortable life ahead and I have wondered if some of her behavioural issues are due to any pain or discomfort, or whether the trauma of a poor start in life followed by the accident and surgery etc are at the root of it, most likely a combination of all these things. Thanks again for your help.  Robyn

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Hi robyna36, wow it sounds like you have been doing everything right by your girl and put a lot of effort in.
Lynsey is right that once a hip has been replaced there is no joint so therfore no arthritis. However, apart from the colateral injuries sustained at the time of the accident (opposite hip/sacrum/spine/knee etc), which can also become arthritic, animals compensate over time for a deficit. Such compensation can result in a variety of changes in the muscles, joints and most importantly – fascia. Muscles weaken, other muscles overwork and become hypertrophied, scar tissue forms and fascia sticks together so muscles no longer move smoothly over each other so tension builds up resulting in pain. Long term pain is amplified by the central nervous system to cause more pain and even pain to things which should not normally cause pain such as being groomed or stroked over a particular body part.
Getting some Galen therapy is very likely to help. Also, Davies now have a pain clinic supported by a physiotherapist and a pain specialist vet who has an advanced knowledge of medication which may help your girl. So if things don’t improve I would strongly recommend going back to see the pain/rehab/physio clinic (not the surgeons – I’m sure they did a fantastic job but what you need here is physio and pain management).
I hope you manage to see some improvement.
All the best
Gwen

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