Canine hip dysplasia: how it is diagnosed, treated, and prevented

In 30 seconds

Hip dysplasia is a hereditary malformation of the coxofemoral joint where the femoral head does not seat properly in the acetabulum. It is the most common orthopedic pathology in medium and large breed dogs. It develops in puppies but typically becomes symptomatic from 5 to 8 months old, or after years of silent progression. Diagnosis is by radiograph under sedation from 12 months for screening (OFA final certification requires 24 months) or PennHIP from 16 weeks. Prevention starts with choosing the right breeder and continues for the whole life of the dog.

Why it appears

Hip dysplasia is multifactorial, but its primary driver is genetic. OFA prevalence statistics for the most predisposed breeds:

Breed	OFA dysplastic prevalence
English Bulldog	73%
Pug	70%
Dogue de Bordeaux	56%
Saint Bernard	47%
Bullmastiff	25%
Rottweiler	21%
Golden Retriever	20%
German Shepherd Dog	19%
Bernese Mountain Dog	16%
Labrador Retriever	12%

Environmental factors that worsen or attenuate the picture:

Worsens	Attenuates
Overweight during growth	Body condition score 4-5/9
Accelerated growth (high-calorie diet)	Large-breed-puppy food with controlled Ca/P ratio
High-impact exercise before 12 months	Low-intensity continuous exercise
Slippery floors (hardwood without rugs)	Floors with traction
Very early spay/neuter in large females (data debated)	Sterilization after growth plate closure

Symptoms

Juvenile form (5 to 12 months)

"Bunny-hopping" gait with rear legs together at the run.
Difficulty rising, especially after rest.
Reluctance to climb stairs or jump.
Intermittent lameness.
Reduced rear-quarter musculature.

Chronic adult form (from age 4 to 6)

Morning lameness or lameness after prolonged exertion.
Reduced spontaneous activity.
Loss of muscle mass in the rear.
Stilted gait, pelvic sway.
Compensatory front-end musculature.

Diagnosis

Veterinary exam

Ortolani test (joint laxity), palpation, gait assessment. Clinical suspicion.

Official radiograph

The definitive test. Done under sedation or general anesthesia to guarantee muscular relaxation (without it the result can be falsified).

Standard positions used in the US:

Method	What it shows	Minimum age
OFA hip extended view	Joint seating in forced extension. AKC accepted for breeding programs	24 months for final certification (preliminary from 4 months)
PennHIP	Quantitative joint laxity (distraction index)	16 weeks

OFA scoring system

Grade	Meaning
Excellent	Superior hip conformation
Good	Normal hip conformation
Fair	Minor irregularities, still passing
Borderline	Inconclusive, retake in 6 months
Mild	Mild dysplasia
Moderate	Moderate dysplasia
Severe	Severe dysplasia

For large breeds, ethical breeders only reproduce Excellent, Good, or Fair dogs per OFA recommendations. PennHIP works on a continuous laxity score rather than a grade.

Treatment

Conservative (the majority of cases)

Pillar	Detail
Weight control	Keep the dog at ideal body condition. Every extra pound multiplies joint load
Adapted exercise	Swimming, slow continuous walking, avoid abrupt direction changes
Veterinary physiotherapy	Hydrotherapy, electrostimulation, massage. Builds protective musculature
Joint supplements	Glucosamine + chondroitin + hyaluronic acid. Moderate evidence
NSAIDs for pain	Carprofen, meloxicam, firocoxib by prescription. Never ibuprofen
Omega-3 (EPA and DHA)	Solid evidence for joint inflammation

Surgical (selected cases)

Surgery	Ideal age	Indication
Juvenile pubic symphysiodesis (JPS)	12 to 20 weeks	Puppies with early-detected laxity
Triple pelvic osteotomy (TPO)	6 to 12 months	Puppies without arthritis but with significant laxity
Total hip replacement (THR)	Adults	Severe cases, best functional outcome
Femoral head ostectomy (FHO)	Any age	Cases where THR not viable. Best in dogs under 55 lb

US ballpark cost (2026):

TPO: $3,500 to $5,500 per hip
THR: $5,500 to $10,000 per hip
FHO: $1,500 to $3,500 per hip

Pet insurance with orthopedic coverage from puppyhood significantly changes the financial calculus for high-risk breeds.

Prevention

Before getting the dog

Only buy from breeders who radiograph both parents and publish the OFA or PennHIP results. Only OFA Excellent, Good, or Fair parents.
If adopting, assume any medium or large dog can develop dysplasia and prepare the prevention plan.

During growth (0 to 18 months)

Large-breed-puppy food with controlled calcium/phosphorus ratio and moderate energy density.
Do not let the puppy get fat. Ribs should be palpable without pressing.
Soft continuous exercise, not explosive. No repeated jumping onto couches, no running up multiple flights of stairs.
Floors with traction at home. Slipping on hardwood accumulates microtrauma in puppies.
Swimming from young, best joint-friendly exercise available.

Lifelong

Weight control, body condition score 4-5/9.
Moderate daily physical activity. Sedentary lifestyle worsens dysplasia.
Omega-3 supplementation from young adult on.

The Smith et al. (2012) study at the University of Pennsylvania showed that lifelong caloric restriction (keeping dogs at lean body condition) delayed the onset of radiographic osteoarthritis by approximately two years in Labrador Retrievers. Weight management is not cosmetic; it is medicine.

What to check

Whether your breed is on the predisposition list.
Whether your breeder OFA-tested both parents and what the results were.
Whether your puppy is growing at a healthy pace (not too fast).
Whether your adult dog's body condition score is in range.
Whether you are seeing intermittent lameness or gait changes you cannot attribute to another cause.