Triple Pelvic Osteotomy Surgery Photos

A very short description of the following surgery

The surgical correction for this problem involves cutting the pubic bone in three places. It is then rotated and re-joined with the use of surgical plates to form a correctly functioning pelvis.

This is Jake. He is our surgical patient.

• The first two slides are meant to help you form a reference point for the joint and surgery that the following slides show.
  Joint Location     Pelvic Drawing
  
• The first part of the procedure involves isolating the pubic bone on the side that the dysplasia is on.
  
  A surgical incision is made and the bone is isolated and cleared of tissue to allow it to be cut in two places.
  
  The piece of bone that is removed is later crushed to become a bone graft at the ilial site.
  The ilial bone is the one toward the dog's nose. Isolating the pubic Bone
  Starting the pubic cut.
  
• Shown here is the saw used to make the cut.
  The Saw used
  
• Once completed this incision is closed with subcuticular sutures. Subcuticular means all the stitches are under the skin.
  close inner thigh incision
  
• The second cut is through the Ischium. The ischium is the bone towards the dog's tail.
  The ischium
  
• After this second cut is made, it will be drilled for a wire, which will later be used to secure the bone back together.
  The ischial Cut
  Drilling to place wire
  
• The sacrotuberous ligament - which is a ligament that bands across from the sacrum to the Ischium - is then cut.
  Sacrotuberous ligament
  
• A wire is passed through the two holes that were previously drilled for use in securing the bone.
  Pass wire through holes
  
• The wound is closed after the incision is complete.
  Close ischium wound
  
• The third and final approach is to the ilium. This is the major wing bone of the pelvis. It is important that this is the last bone cut because this is where the plate goes to secure the wing back together. First the bone is exposed.
  the ilium
  
• Once exposed, the bone is cut with a nitrogen saw just behind the sacrum.
  Cutting the Ilium
  
• This frees up the piece of pelvis, allowing rotation to a normal position. At that point, the plate attachment can begin.
  Start plate attachment
  
• First the distal part of the plate (the piece farthest from the dog’s nose) is attached.
  The distal part of the plate
  
• Plates are attached with screws which have been drilled and pre-tapped. Then the front half of the plate is attached.
  Drill screws
  
• At this point the procedure is done. The next step is closing the incisions. Once completed x-rays are taken to make sure alignment is just right.
  Healing x-ray of TPO
  
  

You can see what a steel plate looks like as this bone is healing and in place. Note that the pelvic bone and the hip socket are deeply seated. This dog will be wonderfully sound and in fact has gone on to have a very normal life.

Follow-up care is critical in these patients. We often hospitalize them for it least
three to four days and sometimes up to three to four weeks. Each patient is individual and we will discuss your dogs' condition with you at the time that the surgery is recommended.

Strict rest is very important, as we do not wish for our patient to fall or further traumatize his leg.

Once healing is under way, recovery will be swift. However, we expect the dogs to be kept confined and without exercise for four months.

As with any surgery, there are potential complications. One potential complication of the TPO is damage to nerves.
Another possible complication is
loosening of the plate. This is why
strict rest is very important.

Your veterinarian will discuss all these possibilities as well as the recovery time with you when making recommendations for your dog. The TPO is not for every dog. We also cannot perform a TPO for dogs with filling in of the hip socket.

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Hip Dysplasia Article

If you have any questions regarding this procedure or any other procedure for your pet, please do not hesitate to call us at 685-4707. As always, we will be happy answer any questions you have regarding your dog or cat.