Canine JPS: Juvenile Pubic Symphysiodiesis for the Prevention of Hip Dysplasia
By Dr. Bob MarquisJuvenile Pubic Symphysiodiesis (JPS) is a procedure originally developed by the University of Wisconsin for the prevention of canine hip dysplasia. This unique approach involves manipulation of the growing puppy's growth plates in the pelvis, allowing the pelvis with conformational abnormalities and early signs of hip dysplasia, to self-correct as it grows.
The procedure fuses the anterior portion of the pubic symphyseal growth plate causing the pelvis to grow in such a way that the acetabulums (pelvic sockets of the hip joints) more completely cover the heads of the femurs. The result is a much more stable and functional hip joint. It should be noted that even though the procedure improves the patient's hips significantly, it does not change his or her genetics and the high likelihood of passing the hip dysplasia gene is still present if bred. Neutering or spaying should be considered.
The JPS procedure needs to be done while the pelvic growth plates (where all the boney growth takes place) are still active. That means between 16 and 20 weeks of age. At that age, most puppies will not yet be showing any signs of an impending problem. It's too early for even a severely dysplastic puppy to have developed any arthritic changes such as cartilage erosion or boney spurs.
The most dependable way to determine if your puppy has the early signs of hip dysplasia (HD) are:
- start with a good physical examination at the time of puppy vaccinations;
- consider breed predisposition (large breed dogs are most likely to have HD in general);
- family history if available; and
- PennHip x-rays in those puppies considered to be at risk.
The PennHip x-rays can effectively determine if a puppy is likely to have HD as early as 16 weeks of age, and affords us a great opportunity to diagnose the problem while we can still do something to prevent it. In addition, while the puppy is anesthetized for the x-rays, his muscles are totally relaxed and we are able to accurately determine any abnormal joint laxity in his hips. This increased and abnormal joint laxity is called a positive Ortolani sign.
If the PennHip x-rays appear normal, and the Ortolani sign is normal, as is the case in the vast majority of puppies, we wake the puppy up and send him or her home. If, however, the PennHip x-rays appear questionable, and there is a positive Ortolani sign, we then would take an additional x-ray view called the DAR view. This gives us a tangential view of the dorsal acetabular rim and we can calculate the angulation of the DAR. If that, too, is abnormal, we would then call the owner, discuss our findings and all options.
If the owner agrees that a JPS is appropriate, we can do the procedure while under the same anesthesia. In most cases the puppy can still go home the same day. No significant exercise restriction is needed. Within 24 hours the puppy can go back to playing in the backyard and being a puppy. As he continues to grow, the pelvis will self-correct and a lifetime of arthritis and pain has been averted.
There are several other advantages to the JPS. Historically, older dogs as old as 18 months, diagnosed with HD have been treated with a very effective surgery called Triple Pelvic Osteotomy (TPO). The JPS procedure costs about 1/10th of what a TPO costs. Patients receiving a TPO require a two to three month period of exercise restriction while those who are treated with a JPS are spending a normal puppyhood playing and moving about naturally without restriction.
Note: Dr. Marquis performed the first JPS surgery done in Colorado in September 2001. He flew with his patient to the Colorado State University School of Veterinary Medicine in Fort Collins. The orthopedic department at CSU had not performed this new procedure yet, so together they consulted with the surgeons at the University of Wisconsin Veterinary School before the surgery. Ursa, a four-month-old Golden Retriever at the time of her JPS, as of this writing, is an athletic 10 year old and having no problems with her hips. Since then, Dr. Marquis and the surgeons at Tiara Rado have performed many successful JPS procedures.
