Hip dysplasia is one of the most common inherited orthopedic conditions in dogs, and one of the most misunderstood. Many owners assume it's a problem only old dogs get, or that it always means surgery. Neither is true. Hip dysplasia is a developmental disease — it begins in puppyhood, often shows its first signs before a dog turns one, and most affected dogs live full, active lives with the right combination of weight management, exercise, and medical care.
What Hip Dysplasia Actually Is
The hip is a ball-and-socket joint: the head of the femur (the "ball") sits inside the acetabulum of the pelvis (the "socket"). In a healthy hip, the ball fits deeply and snugly, and a layer of smooth cartilage allows frictionless movement. In a dysplastic hip, the joint is loose — the ball doesn't seat properly in the socket. This looseness, called joint laxity, is the primary defect in canine hip dysplasia. Every step subjects the cartilage to abnormal grinding forces, and over months and years that grinding produces secondary osteoarthritis, which is what most owners eventually notice as stiffness or limping.
It is important to understand that the laxity comes first and the arthritis comes later. By the time a dog is visibly painful, the joint has often been remodeling for a long time. This is why early screening and early intervention matter so much.
Which Dogs Are at Risk
Hip dysplasia is a polygenic, inherited condition — meaning many genes contribute, and the trait is passed from parents to offspring. According to the Orthopedic Foundation for Animals (OFA), the overall prevalence of canine hip dysplasia in dogs evaluated in their registry is roughly 15%, but the rate varies enormously by breed, from over 70% in some bulldog populations to essentially 0% in sighthounds like the Italian Greyhound.
Breeds with the highest documented risk include the German Shepherd, Labrador Retriever, Golden Retriever, Rottweiler, Bernese Mountain Dog, Newfoundland, Saint Bernard, and Mastiff. Most large and giant breeds carry meaningful risk. While genetics set the ceiling, environmental factors decide how high the disease climbs: rapid growth in puppyhood, excess body weight, unbalanced calcium and energy intake, and high-impact exercise on immature joints all worsen outcomes in genetically predisposed dogs.
Early Warning Signs
Hip dysplasia often shows two distinct waves of clinical signs. The first wave appears in young dogs, typically between 4 and 12 months of age, when joint laxity is at its worst. The second wave appears in middle-aged and older dogs as secondary arthritis takes over. Owners should learn to recognize both:
- "Bunny-hopping" — running with both back legs together rather than alternating.
- Difficulty rising, especially after rest or first thing in the morning.
- Reluctance to jump, climb stairs, or get into the car.
- A swaying or "wobbly" gait in the hindquarters.
- Audible clicking from the hip during movement.
- Loss of muscle in the back legs while the shoulders and forelimbs may look overdeveloped, because the dog is shifting weight forward.
- Reduced willingness to play, lying down after short periods of exercise, or showing pain when handled around the hips.
Many of these signs are subtle and easy to attribute to "just getting older" or "being a lazy dog." A dog that suddenly stops doing something it used to enjoy is almost always communicating something. When in doubt, a veterinary exam is warranted.
How Hip Dysplasia Is Diagnosed
Diagnosis combines a physical exam with imaging. On exam, a veterinarian will check range of motion, look for pain on hip extension, and may perform the Ortolani sign test under sedation, which detects the looseness characteristic of dysplastic hips. The definitive diagnosis, however, is radiographic.
Two formal screening systems are used in North America. The OFA evaluation uses a single ventrodorsal hip-extended radiograph and assigns a grade from Excellent to Severe. OFA certification requires the dog to be at least 24 months old. PennHIP uses three radiographs to measure the distraction index, an objective number quantifying joint laxity, and can be performed reliably in puppies as young as 16 weeks. Because PennHIP measures laxity directly — the underlying defect rather than the downstream arthritis — it can identify at-risk dogs earlier, which opens the door to preventive surgery in selected puppies.
Conservative (Non-Surgical) Management
The majority of dogs with hip dysplasia are managed without surgery, and many do extremely well. Conservative management rests on four pillars.
Weight control is the single most powerful intervention. The landmark Purina Lifespan Study followed 48 Labrador Retrievers from puppyhood and found that dogs kept lean throughout life developed clinical osteoarthritis later, less often, and less severely than their littermates fed 25% more food. For a dog with bad hips, every extra pound is amplified through the joint. The same study showed lean dogs lived a median of nearly two years longer.
Targeted exercise builds the muscle that stabilizes loose joints. Low-impact activity is best: leash walks, swimming, and underwater treadmill therapy are excellent. Avoid repetitive jumping, hard ball-fetching on slick floors, and sudden bursts of high-speed play, especially in puppies whose growth plates are still open.
Pain and inflammation control is the medical layer. Veterinary nonsteroidal anti-inflammatory drugs (NSAIDs) such as carprofen, meloxicam, and grapiprant (Galliprant) reduce arthritic pain. Newer anti-nerve-growth-factor monoclonal antibodies (bedinvetmab, marketed as Librela) are now widely used for chronic osteoarthritis pain in dogs and offer a once-monthly injectable option. Never give human ibuprofen, naproxen, or acetaminophen — they are toxic to dogs.
Joint support includes omega-3 fatty acids (EPA and DHA from fish oil), which have evidence for reducing arthritic inflammation, and rehabilitation modalities like physical therapy, hydrotherapy, and laser therapy. Glucosamine and chondroitin supplements are commonly used; the evidence is mixed but they are low-risk.
Surgical Options
When conservative management isn't enough, several surgeries can dramatically improve quality of life. The right choice depends on the dog's age, size, and the severity of joint changes.
Juvenile pubic symphysiodesis (JPS) is a minimally invasive procedure performed in puppies under about 20 weeks old, before the joint has remodeled. It causes part of the pelvis to fuse early, redirecting growth and producing a deeper hip socket. It only works in very young, carefully selected patients — which is why early PennHIP screening can be so valuable.
Double or triple pelvic osteotomy (DPO/TPO) rotates the pelvic bones to provide better coverage of the femoral head. It is reserved for young dogs (typically under 10–12 months) with significant laxity but minimal arthritis.
Total hip replacement (THR) replaces the diseased joint with a prosthesis, in the same way human THR works. Studies report success rates above 90% and a return to near-normal function. THR is the gold standard for medium-to-large dogs with severe arthritis once skeletally mature.
Femoral head ostectomy (FHO) removes the femoral head entirely, allowing a "false joint" of fibrous tissue to form. It is most successful in dogs under about 40 lbs and serves as a salvage option when THR is not available or affordable. Function is good but not perfect — many FHO dogs show some permanent gait changes.
What You Can Do Right Now
If you have a puppy of an at-risk breed, ask your veterinarian about PennHIP screening before 6 months of age and feed a large-breed puppy food formulated for controlled growth. Keep your dog lean throughout life — you should be able to feel ribs easily without seeing them, and there should be a visible waist when viewed from above. Provide consistent, moderate exercise rather than weekend warrior bursts. And if you notice any of the warning signs above, don't wait. Hip dysplasia is one of those conditions where the sooner you act, the more options you have.