Surgery Guide
TPLO vs Total Hip Replacement: Different Joints, Different Surgeries
TPLO vs total hip replacement: one repairs a torn knee ligament, the other replaces the hip joint with an implant. Costs, recovery, and which one your dog needs.
No — a TPLO is not a hip replacement. TPLO treats a torn cranial cruciate ligament in the knee by cutting and rotating the top of the tibia so the joint is stable without the ligament; a total hip replacement (THR) removes a diseased hip's ball and socket and replaces them with implants. Different joints, different diseases, different hardware — and this guide walks through both.
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Why do people mix these up?#
The confusion is reasonable. Both are major orthopedic surgeries on a dog's back leg, both are quoted in the thousands of dollars, both come with roughly two-month activity restrictions, and both get recommended for large breeds that showed up at the vet with a rear-leg limp. Search results blur them further, because gear, recovery advice, and cost questions overlap almost completely.
But they are answers to two unrelated problems. A dog is recommended a TPLO because a ligament in the knee failed. A dog is recommended a THR because the hip joint itself — the ball and socket — is malformed or worn out. Understanding which problem your dog has tells you which surgery conversation you're actually in.
What does a TPLO actually do?#
The cranial cruciate ligament (CCL) — the canine equivalent of the human ACL — stops the femur from sliding backward off the top of the tibia every time the dog bears weight. CCL rupture is one of the most common orthopedic injuries in dogs, and unlike the human ACL it usually fails by slow degeneration rather than one bad landing.[1]
The TPLO's insight is that you don't have to rebuild the ligament — you can make it unnecessary. The surgeon cuts the top of the tibia, rotates the sloped plateau until it sits nearly level, and fixes it with a plate and screws. On the leveled surface, the femur no longer tries to slide during weight-bearing, so the joint is stable without a CCL.[2] Nothing artificial replaces the joint; the dog keeps its own knee, plus a plate that usually stays in for life.
The cost of that stability is a bone cut that needs about eight weeks to heal, which is what drives the strict recovery — the full arc is in our TPLO recovery guide.
What does a total hip replacement actually do?#
THR is exactly what the name says. The hip is a ball-and-socket joint, and in dogs with hip dysplasia the joint develops loose and misshapen, grinding itself into painful arthritis over years. When medical management stops working, THR removes the diseased hardware entirely: the femoral head and neck (the ball) come off and are replaced with a metal stem and head, and the acetabulum (the socket) is reamed out and fitted with a cup that the new ball rides in.[3]
The result is a true artificial joint — the arthritic bone-on-bone surfaces are gone, which is why THR is regarded as the gold-standard surgical treatment for severe hip dysplasia. It's also a more specialized procedure than TPLO: fewer surgeons perform it, it requires dedicated implant systems, and candidates are screened for infection risk and bone maturity. Recovery under typical protocols runs 8–12 weeks of strict, progressive restriction, with early weeks focused on preventing the new hip from luxating before the tissues around it tighten. As with everything else on this page, your surgeon's instructions are the protocol.
TPLO vs THR, side by side#
| TPLO | Total hip replacement (THR) | |
|---|---|---|
| Joint | Stifle (knee) | Hip |
| Problem it treats | Torn or partially torn cranial cruciate ligament | Hip dysplasia with arthritis, severe hip osteoarthritis, some fractures and luxations |
| What the surgeon does | Cuts and rotates the top of the tibia to level the plateau, fixes it with a plate and screws | Removes the femoral head and neck, implants a stem, head, and socket cup |
| What's implanted | Bone plate and screws — the dog keeps its own joint | A full prosthetic ball and socket — an artificial joint |
| Typical US cost | Roughly $3,500–$6,500 per knee, varying by region and practice type | Roughly $5,500–$8,000+ per hip, varying by region and practice type |
| Typical restriction window | About 8 weeks strict, off-leash play around week 12 (typical protocols) | About 8–12 weeks strict, progressive return over the following months (typical protocols) |
| Availability | Very widely performed by board-certified surgeons | Fewer centers; requires specialized training and implant systems |
| Success framing | Surgeons commonly quote 90%+ good-to-excellent outcomes | Surgeons commonly quote around 90–95% of dogs returning to normal or near-normal function |
| The "other side" risk | Roughly 40–50% of dogs tear the opposite CCL within about 18 months | Hip dysplasia is usually bilateral; some dogs eventually need or benefit from the second hip done |
Which one does my dog actually need?#
Not your call to make from the couch, and not diagnosable from a limp video — rear-leg lameness looks remarkably similar across causes. What you can do is bring good observations to the exam: when the limp is worst, whether rising is the hard part, whether your dog sits square or kicks a leg out, what stairs look like. Our guide to telling if your dog is in pain covers what's worth writing down.
From there, it's the vet's job. Knee: palpation tests for instability (cranial drawer, tibial thrust), joint effusion, and radiographic signs. Hip: pain on extension, laxity, and radiographs that show the dysplastic remodeling. Sedated radiographs are common and worth saying yes to — a relaxed dog gives diagnostic films.
One thing worth internalizing: the same big breeds — Labs, German Shepherds, Rottweilers, Goldens — are overrepresented in both diseases, and plenty of dysplastic dogs tear a CCL. That's why the diagnosis, not the breed reputation, has to drive the plan. It's also why a dog can genuinely need both surgeries in one lifetime, staged months apart, most painful joint first.
What if a THR isn't in the budget?#
There's an established fallback: femoral head ostectomy (FHO). The surgeon removes the femoral head and neck and does not replace them; over the following weeks, scar tissue forms a "false joint" between femur and pelvis. The grinding bone-on-bone contact is gone, so the pain relief is real, but the mechanics are never fully normal — expect a slightly odd gait and some lost range of motion. FHO works best in cats and smaller dogs, where less mass rides on the false joint; in large dogs, results are more variable and rehab effort matters more. It typically costs a fraction of a THR and is available at most general practices.
Between surgery and nothing, there's also structured medical management — weight control, joint supplements, pain medication, physical rehab. It doesn't fix the joint, but it's how many dysplastic dogs live comfortably for years; see our joint supplement rankings for that piece of the puzzle.
The recovery gear overlaps almost completely#
Whichever surgery your dog has, the home setup is nearly identical: confinement, traction, no stairs or jumping, and a way for you to assist a big dog's rear end without wrecking your back. Two items do the heaviest lifting in both recoveries.
#1 Pick
GingerLead
GingerLead Dog Support and Rehabilitation Harness
Our score
$35–$90
Best for
Short-term post-surgical assistance and rear-end weakness
The right tool for post-surgical rear-end weakness in the first 4–6 weeks. Easy to handle, easy to wash, and the gendered models are a thoughtful detail. For long-term mobility support, step up to the Help 'Em Up Harness.
Pros
- Single-piece sling — fast to put on for bathroom trips
- Padded female and male versions account for anatomy and avoid soiling
- Integrated leash takes one accessory off your hands
- Less than half the cost of Help 'Em Up
Cons
- Rear-end only — not the right tool if a dog also needs front support
- Long-term use can rub thighs without careful fitment
- Strap-end handles are less ergonomic than padded handles
The GingerLead's single-piece design is the fast assist for the early weeks — under the belly in seconds for bathroom trips, with an integrated leash. Rear-end support is exactly what both TPLO and THR dogs need, though for a fresh THR ask your surgeon to demonstrate assisted walking first; early hip patients need controlled, aligned support, not enthusiastic lifting.
#2 Pick
Help 'Em Up
Help 'Em Up Harness
Our score
$95–$155
Best for
Long-term mobility support for senior or post-surgical large dogs
If your dog needs help getting up multiple times a day for the foreseeable future — post-TPLO, advanced hip dysplasia, hindquarter weakness in giant-breed seniors — this is the one to buy. It is the only harness in the category that supports the front and the back independently, which is what a dog with a bad hip and a compensating shoulder actually needs. Buy it from the manufacturer, not from Amazon: the same harness is $80 direct in every size.
Pros
- Two-piece (chest + hip) design lets you support either end independently
- Hip handle is purpose-built — not a converted car-seat-belt strap
- Padded chest plate distributes weight better than sling-only options
- Five sizes span 10 to 225 lb, and the rear half can be ordered a size smaller for a dog with muscle wasting
- Two hip-lift styles (Conventional and U-Band) so male dogs are not soiling the strap
Cons
- Amazon charges $15–$75 more than the manufacturer's own site, which sells every size at $80
- Sizing is critical — measure twice, return is a hassle
- Rear straps can chafe the inner thigh if the harness is left tight while the dog lies down
- Bulkier than a quick-grab sling for short-term use
For big dogs and longer recoveries, the Help 'Em Up two-piece harness stays on all day and gives you a purpose-built hip handle — the tool rehab practices reach for with 80-pound-plus patients, and worth the price for a bilateral-disease dog you'll be assisting for months. More options in our lift harness guide.
The rest of the kit — firm low bed, gates, ramp, cone — is covered in the TPLO recovery gear checklist, and the same list serves a THR household. So do the stair rules, which THR surgeons enforce just as firmly.
The bottom line#
TPLO and total hip replacement aren't competing options — they're different repairs for different joints. If your dog's problem is a torn cruciate, the conversation is TPLO (roughly $3,500–$6,500 per knee, typical US range). If the problem is a worn-out, dysplastic hip, the conversation is THR (roughly $5,500–$8,000+ per hip), with FHO as the budget-conscious fallback. A board-certified surgeon — the kind ACVS certifies — will confirm which conversation you're in with an exam and radiographs, and both procedures carry excellent odds when the diagnosis is right and the recovery is followed.
The part you control is the same either way: the questions you bring to the consult, the home you set up before surgery day, and eight-plus disciplined weeks on the other side.
Frequently asked
- Is a TPLO the same thing as a total hip replacement?
- No. A TPLO is knee surgery: it treats a torn cranial cruciate ligament by cutting and rotating the top of the tibia so the knee is stable without the ligament — nothing is replaced. A total hip replacement removes the ball and socket of the hip and replaces them with implants. Different joint, different disease, different hardware, different price.
- Which costs more, a TPLO or a dog hip replacement?
- Total hip replacement costs more. In the US, TPLO typically runs $3,500–$6,500 per knee, while THR typically runs $5,500–$8,000 or more per hip — both varying widely by region and by whether you're at a specialty practice or a university hospital. THR is also offered at fewer centers, since it requires specific implant systems and additional surgeon training.
- Can a dog need both a TPLO and a hip replacement?
- Yes — they treat different joints, and the breeds prone to cruciate tears (Labs, Rottweilers, German Shepherds) overlap heavily with the breeds prone to hip dysplasia. Surgeons stage the procedures, addressing the most painful joint first, with full recovery between them. A dog with both knee and hip disease needs a board-certified surgeon to sequence treatment — not two surgeries at once.
- What is the cheaper alternative to a total hip replacement?
- Femoral head ostectomy (FHO). The surgeon removes the femoral head — the ball — and the body forms a fibrous false joint. It typically costs a fraction of a THR, is widely available, and relieves bone-on-bone pain, but the mechanics are never fully normal afterward. It works best in lighter dogs and cats; large-breed outcomes are more variable. Discuss both options with a surgeon.
- How do I know if my dog's back-leg limp is the knee or the hip?
- You usually can't tell from watching — that's the exam's job. Suggestive patterns: a cruciate dog often sits with the sore leg kicked out to the side and limps worse after rest; hip dysplasia more often shows as bunny-hopping, trouble rising, and reluctance on stairs. Vets confirm with palpation tests and radiographs, sometimes under sedation. Don't self-diagnose a rear-leg limp.