Our Services

TPO Surgery

TPO Surgery

When a dog has hip dysplasia — an abnormal formation of the hip socket — it’s imperative to correct the looseness in the hip joint as early as possible, to prevent crippling lameness, painful bone spurs and the progressive loss of cartilage. If left untreated, arthritis can set in as early as seven months of age. Triple Pelvic Osteotomy, or TPO surgery is a common surgical method to tighten and improve the laxity in the hip joint, where severe arthritis develops.

Why It Happens

The biggest single risk factor is hereditary. It boils down to genes. Granted, rapid weight gain can exacerbate hip dysplasia, which is most common among large-breed dogs, such as Labradors, Rottweilers, German Shepherds and Golden Retrievers. The first stage of hip dysplasia is looseness of the hip joints. If the joint is loose, the hip partially dislocates with each step the dog takes and the joint gradually becomes deformed. The socket becomes shallow and the head of the femur becomes flattened. Arthritis develops in the joint and causes pain. Occasionally only one hip has dysplasia, but more commonly both hips are affected.

Clinical signs of hip dysplasia can be seen as early as four months of age; however, many dogs are 8–12 months of age. Symptoms include a sudden aversion to exercise or an awkward gait of the hind limbs. You may notice your puppy or dog “bunny hopping” or experiencing stiffness on rising after a rest. Early intervention is key, before arthritis sets in and a total hip replacement is required.

Ideal Candidates for TPO

We recommend TPO surgery for dogs under one year old, with minimal or no arthritis. Upon physical examination, our doctors should be able to feel the hip pop in and out of the joint crisply. The angle at which the hip pops back in the joint should not be more than 40 degrees. Otherwise, a total hip replacement may be necessary. Again, prevention with early intervention is the goal.

How TPO Surgery Works

The pelvis is cut in three separate places — thus the word “triple” in the surgery’s name — and the socket is rotated to create a better, smoother ball-and-socket connection. A steel plate and screws are then used to secure the pelvis into this new, rotated position.

Our primary surgeon, Dr. Richardson, uses a large-screen TV to show explanatory videos about TPO and to show X-rays of your dog’s hip dysplasia. The videos, the X-rays and 3D models in the clinic effectively describe what the procedure entails and exactly how we’ll go about stabilizing the hip joint.

Benefits of TPO

TPO surgery is well tolerated. We continue to see rapid recovery, restored joint stability and a return to regular agility. Over 90% of dogs experience no complications and require no long-term pain medication. Surgical outcome is greatly improved when you do not allow your dog to lick at the surgery site, which causes infection. Activity must be restricted to leash walks until the osteotomy sites (places where the bone was cut) are healed, generally around six weeks. Most dogs are able to comfortably bear weight soon after surgery, so your pet must be closely confined and supervised to prevent overuse of the leg during the healing period. We have a comprehensive program to educate pet owners in post-op care at home. Before discharging any pet, we make sure you have a thorough understanding of how to assist in your dog’s recovery.


If your dog is still a puppy and approximately four months old — but no older than five months — then you may want to consider JPS (Joint Pubic Symphysiodesis) surgery, which also improves the ball-and-socket connection in the hip joint. While this procedure is more economical for pet owners, please note there is a very tight window of opportunity for this surgical option, as it relies on the continuing growth of your puppy. Our doctors can consult with you about the best options for your pet.