what are the current medical and surgical management options for canine hip dysplasia by age and severity?

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Canine hip dysplasia (CHD) management is stratified by patient age and disease severity, with the primary decision points being: immature dog with laxity only, immature dog with early degenerative joint disease (DJD), and mature dog with established osteoarthritis (OA).28 --- In immature dogs (≤16 weeks), juvenile pubic symphysiodesis (JPS) is the earliest surgical option. JPS is indicated for dogs with mild to moderate hip laxity confirmed by a positive Ortolani sign at 12 weeks of age, and it improves joint congruity, decreases laxity, and can reverse or prevent progression of DJD when performed at the appropriate age.14 JPS is best understood as a preemptive procedure rather than a therapeutic one — it is not appropriate for hips with advanced laxity or existing DJD.14 For dogs aged 4–6 months with hip dysplasia and insufficient acetabular coverage, double pelvic osteotomy (DPO) is a primary surgical intervention. DPO, along with triple pelvic osteotomy (TPO), redirects the acetabulum to improve femoral head coverage and reduce subluxation forces.15 Modern DPO and TPO plate designs have been refined to reduce complication rates, and constructional changes in current implants represent a meaningful advance over earlier systems.5 Patient-specific and off-the-shelf 3D-printed acetabular rim extension implants represent an emerging surgical alternative, designed to improve femoral head coverage and stability while enabling bilateral single-stage application to reduce overall recovery time; off-the-shelf versions aim to reduce production time and cost compared to individualized implants by using standard radiography rather than CT for planning.3 In mature dogs with established OA who fail conservative management or have severe disease affecting quality of life, total hip arthroplasty (THA) is the gold standard surgical option, with a reported success rate of greater than 95%.6 Femoral head and neck excision (FHO, also called femoral head and neck ostectomy) is an alte