When other procedures, such as TPLO, TPO and JPS, fail to stop hip pain in dogs and some cats, we recommend Femoral Head Ostectomy, or FHO surgery, as a salvage procedure or last resort, especially when your pet is not a candidate for total hip replacement. It’s performed when hip joint disease or a shattered femur (i.e., from trauma or a severe accident) results in continuing pain for your pet, and other methods of treatment are not feasible or did not produce the desired results.
Ideal Candidates for FHO
As well as treating hip dysplasia and accident victims, FHO surgery is used to treat dogs with Legg-Calvé-Perthes Disease. While there are no specific weight guidelines for an FHO, smaller dogs and some cats typically have better outcomes since less stress and force is carried on the false joint (see below) than would be in a large-breed dog. Still, this procedure may be recommended in large dogs in which other treatments have been ineffective or are not feasible. It can dramatically improve the quality of life in dogs with painful arthritic hips.
How FHO Surgery Works
FHO involves the removal of the “ball” part of the ball-and-socket that makes up the hip joint. This way, the bones of the joint are no longer in contact, which eliminates the pain that is caused by the abnormal contact of the bones in a pet with hip dysplasia or severe osteoarthritis. Once the femoral head and neck are removed, the surrounding muscles and developing scar tissue work as a “false joint” to support the area. No implants or replacements are required.
The procedure causes the leg to be slightly shorter than the “good” leg, although most pets return to near-normal activity after the surgery. Your pet may always have some degree of lameness, even when proper rehabilitation is done. This does not mean the surgery has failed, but is due to the fact that your pet is operating with a false joint and a slightly shortened leg, and so the dynamics of the hip have completely changed. While some degree of lameness may still be present, it will most likely be a big improvement over your pet’s earlier gait and level of discomfort.
Our primary surgeon, Dr. Richardson, uses a large-screen TV to show explanatory videos about TPO and to show X-rays of your dog or cat’s hip dysplasia. The videos, the X-rays and 3D models in the clinic effectively describe what the procedure entails specific to your pet.
Benefits of FHO
FHO surgery is well tolerated. Even if your pet does not return to 100% use of the limb, he or she should be more pain free after surgery. Surgical outcome is greatly improved when you do not allow your dog or cat to lick at the surgery site, which causes infection. Postoperative care and physical therapy are extremely important for a favorable outcome. Physical therapy may begin after sutures are removed (if your pet has skin sutures) and is very important for maximum return of limb use. If possible for dogs and if they are already accustomed to it, swimming should be started after the incision has healed. Allow your dog to paddle in the water to exercise the limb and joint. This increases the range of motion, strength and your dog’s confidence in using the leg. Slow, short leash walks are recommended.
With time and increasing limb strength, more vigorous exercise may begin. Most pets will start to bear a small amount of weight on the limb within two weeks after surgery. Within 4–6 weeks, your pet should bear a moderate amount of weight on the limb. By 4–6 months after surgery, recovery is complete, depending on the size of your pet and the level of trauma — if trauma was indeed a factor.
We have a comprehensive program to educate pet owners in post-op care at home. Before discharging your pet, we make sure you have a thorough understanding of how to assist in your pet’s recovery.