Hip Dysplasia in Dogs: What Every Owner Should Know   Sources: PubMed · OFA · Journal of the American Veterinary Medical Association · La Semaine Vétérinaire Star's Pic : Fidji

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Dogs are born with their genes, not with hip dysplasia

This is probably the most important fact to understand because it changes the way we think about this disease.

A puppy genetically predisposed to hip dysplasia is born with hips that are, at birth, clinically normal. The condition develops gradually during growth as genetics interact with environmental factors.

In other words, dysplasia is not something a puppy is born with. It is a progressive disorder, and while genetics play a major role, they are not the whole story. That distinction matters because it means some risk factors can be influenced.

Studies estimate that around 15–20% of dogs are affected overall, although the prevalence varies enormously between breeds. Loder & Todhunter, 2017 – analysis of more than 921,000 OFA records.

Hip dysplasia is also the leading cause of secondary osteoarthritis in adult dogs. What happens inside a puppy's hips during the first months of life can shape its joint health for years to come.

What hip dysplasia actually is

Hip dysplasia, or coxofemoral dysplasia, is a developmental abnormality affecting the fit between the head of the femur and the hip socket (acetabulum).

In a healthy hip, the femoral head sits securely inside the socket while the surrounding ligaments and joint capsule keep the joint stable. Movement is smooth, controlled and painless.

 

With hip dysplasia, that stability is compromised.

Because the joint is too loose (a phenomenon known as joint laxity) the femoral head shifts slightly every time the dog moves. Over time, this repeated instability damages the joint.

Instead of gliding smoothly, the femoral head repeatedly places abnormal pressure on the cartilage. The cartilage gradually wears down, the socket begins to deform, inflammation develops, and secondary osteoarthritis slowly takes hold.

Unfortunately, these changes are often permanent once established.

 

 

One important point to remember X-ray findings do not always reflect how much pain a dog is experiencing. Some dogs with severe radiographic changes remain surprisingly comfortable because they compensate well with strong muscles and adapted movement. Others may experience significant pain despite relatively moderate lesions. Pain perception, muscle mass, lifestyle and activity level all influence how a dog copes with the disease. Radiographs show the joint, they do not measure the dog's comfort.

Some breeds are far more affected than others

Large epidemiological studies consistently show major differences between breeds.

A study published by Loder & Todhunter (2017), based on 921,046 OFA records, reported striking variations in prevalence. Similar trends were confirmed in France by Genevois et al. (2008).

Breed	Estimated prevalence
English Bulldog	~77%
Cane Corso	~59%
German Shepherd	~22%
Rottweiler	~20%
Golden Retriever	~19%
Bernese Mountain Dog	~16%
Labrador Retriever	~11%
Siberian Husky	~3.9%
Italian Greyhound	~0%

Sources: Loder & Todhunter (2017); Genevois et al. (2008).

Large and giant breeds are particularly susceptible because rapid skeletal growth can temporarily outpace muscular development. During this period, the muscles may not yet provide enough support to stabilize the rapidly developing joints.

How the disease changes over time

Hip dysplasia does not look the same throughout a dog's life.

Clinical signs evolve as the joint changes, and two dogs of the same age may show completely different symptoms.

Puppies (5–15 months)

The first signs are usually linked to joint laxity.

Owners may notice:

• a swaying gait, with the hindquarters moving from side to side;

• the classic "bunny hopping" run, where both hind legs move together;

• reluctance to climb stairs or jump;

• reduced stamina during exercise;

• less interest in playing than before;

• discomfort or pain when the hips are manipulated.

These signs may appear gradually (or sometimes surprisingly quickly.)

The deceptive "improvement" around one year of age

One of the most misleading stages of hip dysplasia occurs between 10 and 12 months of age.

As the puppy grows, muscle development improves joint stability. Many dogs appear to move better, and the obvious signs of pain may decrease.

It is easy to assume the problem has resolved.

In reality, it often hasn't.

While the dog may appear more comfortable, osteoarthritis can continue to develop quietly in the background. This temporary improvement should never replace appropriate monitoring or veterinary follow-up...Quite the opposite (it is often the ideal time to intervene before irreversible joint damage becomes established).

 

 

Diagnosing hip dysplasia

Only a veterinarian can confirm a diagnosis. No single test is sufficient on its own, so diagnosis relies on a combination of clinical examination and imaging.

Orthopedic examination: the Ortolani test

The Ortolani test is the reference clinical examination for detecting hip laxity in young dogs.

Performed under sedation, it allows the veterinarian to feel whether the femoral head slips out of the socket before returning to its normal position. In dogs with marked instability, this movement may even produce an audible "clunk."

A positive Ortolani test does not automatically mean a dog will develop severe osteoarthritis, but it is a strong indicator that the joint lacks stability.

PennHIP: detecting risk as early as 16 weeks

The PennHIP method measures the distraction index, an objective indicator of joint laxity.

Unlike standard hip radiographs, PennHIP can be performed from 16 weeks of age, making it one of the earliest tools available to estimate a puppy's future risk of developing hip osteoarthritis.

It is widely regarded as the most predictive screening method currently available and is particularly valuable for responsible breeding programmes.

Official hip radiographs

In many countries, official hip screening relies on standard radiographs taken once skeletal maturity has been reached.

In Europe, hips are graded according to the FCI classification, from A (normal) to E (severe dysplasia).

In North America, the Orthopedic Foundation for Animals (OFA) uses categories ranging from Excellent to Severe.

One important limitation should be kept in mind.

A young dog may have significant joint laxity while still showing relatively normal radiographs because osteoarthritis has not yet developed. This is one reason why PennHIP is often recommended for early risk assessment in predisposed breeds.

What increases the risk and what helps reduce it

Genetics are a major driver of hip dysplasia, but they are only part of the equation.

Several environmental factors influence how severely the disease develops.

Factors associated with a higher risk

• Excessive calorie intake during growth :

Rapid weight gain places additional stress on immature joints. A landmark study by Kealy et al. (1992) found that Labrador Retrievers fed approximately 25% fewer calories throughout growth developed significantly less severe hip dysplasia than genetically similar littermates fed freely.

 

• Being overweight :

Extra body weight increases mechanical stress on unstable joints and accelerates the progression of osteoarthritis. Keeping a dog lean is one of the most effective long-term strategies for preserving joint function.

 

• High-impact exercise in growing puppies :

Repeated jumping, intense ball chasing, or strenuous exercise on hard surfaces may increase stress on developing joints. Regular activity remains important (but it should be appropriate for the puppy's age and stage of development).

 

• Early neutering

Several studies have reported an association between early neutering and an increased risk of joint disorders in certain breeds, including Golden Retrievers and German Shepherds. The relationship is complex and does not apply equally to every breed, but it is an important discussion to have with your veterinarian before making decisions about the timing of neutering.

 

Protective factors

Although no preventive strategy can completely eliminate genetic risk, several measures are consistently associated with better long-term joint health.

These include:

• maintaining a lean body condition throughout life;

• providing regular, low-impact exercise such as walking or swimming;

• feeding a diet appropriate for the dog's expected adult size without excessive calorie intake;

• scheduling regular veterinary follow-up for breeds known to be at increased risk.

No supplement, exercise programme or management strategy can change a dog's genetics.

However, good management can have a meaningful impact on how the disease progresses and on a dog's quality of life.

Treatment options

Hip dysplasia cannot be "cured" in the strict sense.

Once the joint has developed abnormally, it cannot return to a normal anatomical structure.

That said, modern veterinary medicine offers many options to reduce pain, preserve mobility and, in selected cases, improve joint function surgically.

 

Conservative management

Most dogs are treated without surgery.

Treatment usually combines several approaches rather than relying on a single intervention.

This may include:

• maintaining an ideal body weight;

• tailored exercise programmes;

• physiotherapy and rehabilitation;

• appropriate pain relief prescribed by a veterinarian;

• joint-support strategies where indicated.

For many dogs, this multimodal approach provides excellent long-term quality of life.

Preventive surgery in young dogs

When hip laxity is detected early enough, surgery may help improve joint development.

Juvenile Pubic Symphysiodesis (JPS) is performed between 14 and 18 weeks of age and aims to improve femoral head coverage by modifying pelvic growth.

Triple Pelvic Osteotomy (TPO) is generally reserved for young dogs—typically between 6 and 10 months of age—before osteoarthritis has become established.

Both procedures depend on early diagnosis. Once degenerative joint changes are present, these surgeries are no longer appropriate.

Total hip replacement

For adult dogs with advanced disease that no longer respond adequately to conservative treatment, total hip replacement is often considered the gold standard.

Although it is a major procedure with significant cost, the outcome can be life-changing, allowing many dogs to return to a comfortable and active life.

 

What you can do today

If your dog belongs to a breed with a higher risk of hip dysplasia—such as a Labrador Retriever, Golden Retriever, German Shepherd, Rottweiler, Cane Corso or other large breeds (early prevention can make a real difference).

Some of the most effective measures are also the simplest :

• Keep your dog lean.

Maintaining a healthy body condition is consistently one of the most effective ways to reduce stress on the hips and slow the progression of osteoarthritis.

 

• Pay attention to subtle changes.

Not every dog with hip dysplasia limps.

Sometimes the first signs are far more discreet: reluctance to jump into the car, taking longer to stand up, climbing stairs differently, tiring more quickly on walks or running with both hind legs together.

These changes are easy to dismiss as personality or ageing, but they deserve attention—especially in young dogs.

 

• Don't wait for obvious lameness.

If your puppy belongs to a predisposed breed, talk to your veterinarian about early screening. Identifying joint laxity before permanent damage occurs offers the greatest opportunity to improve long-term outcomes.

 

• Don't be reassured too soon.

Many puppies appear to improve around one year of age as their muscles develop.

This apparent recovery can be misleading.

Even if the dog seems more comfortable, osteoarthritis may continue to progress silently. Continued monitoring remains important, particularly if symptoms were present earlier in life.

Ultimately, hip dysplasia is much easier to manage before extensive joint degeneration has developed.

 

More than a hip problem

Hip dysplasia is often viewed as a simple orthopaedic disease. In reality, it is a lifelong condition that influences how a dog moves, exercises, rests and ages. Early diagnosis cannot change a dog's genetics, but it can profoundly change its future. Appropriate weight management, sensible exercise, regular veterinary follow-up and timely treatment can delay the onset of osteoarthritis, reduce pain and help many dogs maintain an excellent quality of life for years.

Perhaps the most important message is :   A genetic predisposition is not a guarantee that a dog will experience the worst possible outcome. Knowledge, early intervention and appropriate management can make a meaningful difference.

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Sources

1. Loder RT, Todhunter RJ. Demographic data on canine hip dysplasia in the United States and Canada. Journal of Veterinary Medicine. 2017:5723476.
2. Genevois JP et al. Prevalence of hip dysplasia based on official radiographic screening among 31 dog breeds in France. Comparative Veterinary Orthopaedics and Traumatology. 2008.
3. Oberbauer AM et al. Long-term genetic selection reduced the prevalence of hip and elbow dysplasia in 60 dog breeds. PLOS ONE. 2017.
4. Kealy RD et al. Effects of limited food intake on the incidence of hip dysplasia in growing dogs. Journal of the American Veterinary Medical Association. 1992.
5. Witsberger TH et al. Prevalence and risk factors of hip dysplasia and cranial cruciate ligament rupture in dogs. JAVMA. 2008.
6. Hart BL et al. Sterilization of German Shepherd Dogs: associated joint disorders, cancers and urinary incontinence. Veterinary Medicine and Science. 2016.
7. La Semaine Vétérinaire (2022). Diagnosis and treatment of hip dysplasia.
8. Le Point Vétérinaire (2016). Early diagnosis of hip dysplasia.
9. Frégis Veterinary Hospital. Hip Dysplasia in Dogs.
10. Centre Hospitalier Universitaire Vétérinaire de Montréal. Hip Dysplasia.