Femoral head ostectomy, often known as an FHO, is a surgical treatment that removes the head and neck of the femur to attempt to restore pain-free hip mobility (the long leg bone or thighbone).
How does an FHO change the hip?
Hip joints typically consist of a ball and socket. The socket of the joint is made up of the acetabulum, which is a piece of the pelvis. The ball that fits inside the socket is made up of the head of the femur, a protrusion from the long bone that lies between the hip and the knee. The hip can move freely in all directions because the acetabulum accommodates the head of the femur.
But this movement may be compromised if the hip is injured or ill. The degree of movement that the joint may acquire can be affected if the acetabulum and the head of the femur do not fit together properly. Additionally, chronic pain and inflammation may result from this inadequate joint fit.
An FHO removes the head of the femur to improve hip mobility. By doing this, the ball of the ball-and-socket joint is removed, leaving an empty socket behind. The femur will initially be held in place by the muscles of the leg, and over time, scar tissue between the acetabulum and the femur will grow to provide cushioning, which is referred to as a “false joint.” Even though this joint is structurally extremely different from a typical hip joint, the majority of patients can move around without any pain.
Is my dog a good candidate for FHO?
Small dogs and cats, especially those that are at a healthy weight and weigh less than 50 pounds, are the main populations for which this surgery is advised. In an FHO, a fake joint is formed that supports the weight of tiny animals quite effectively, but it may be less successful for large-breed canines. There are, however, exceptions, and veterinarians occasionally advise an FHO even for a dog exceeding 50 pounds if the circumstances of the case require it.
FHO frequently produces greater effects in more active dogs than in less active dogs. The dog is able to regain pain-free movement more rapidly than inactive pets because of the muscular mass that has been developed through activity, which helps to support the joint. Dogs that aren’t active have less muscle around the joint, which makes the joint less stable after surgery and prolongs healing.
Why is an FHO performed?
An FHO’s main objective is to eliminate bone-on-bone contact and restore pain-free mobility. The following are the most typical causes of FHO:
- hip fractures are fractures. An FHO might be the best alternative for pain-free mobility when a fracture affects the hip joint and cannot be treated surgically (either due to patient considerations or cost considerations for the owner).
- Hip dislocation or luxation (associated with trauma or severe hip dysplasia). In rare situations, manipulation or other surgical procedures are unable to replace a hip that is out of place. For tiny dogs with hip luxations, many dog owners choose FHO because surgical treatment of the condition can be expensive and unsuccessful in some cases.
- hip arthritis that is very bad. The cartilage that covers the acetabulum and the head of the femur can become worn away in chronic, end-stage arthritis, resulting in excruciating bone-on-bone clicking anytime the hip is moved. An FHO can eliminate this point of contact and reduce pain.
- a Legg-Perthes condition (also known as avascular necrosis of the femoral head). The femoral head bone begins to deteriorate early on as a result of this rare ailment, which is most typically observed in toy and small breed dogs. These degenerative changes cause the bone to collapse, which causes excruciating pain. The dog’s source of pain is eliminated by removing the femoral head with FHO.
What can I expect on the day of surgery?
The patient is given general anaesthesia for this procedure. On the day of the operation, you will often bring your dog to the veterinary facility early in the morning. To avoid possible anesthetic-related vomiting, your veterinarian may advise you to refrain from eating the morning of surgery.
Depending on the particulars of his health and surgery, your dog may need to stay in the hospital for a few hours or a few days after surgery. Your dog’s operated limb most likely won’t be carrying any weight when you pick him up from the hospital. There will be an obvious incision at the hip, and this incision may or may not have external sutures that are visible. Under the skin sutures that dissolve are sometimes used by veterinarians. For the purpose of preventing licking at the surgery site, your dog will probably be wearing an Elizabethan collar (cone).
What care will my dog need after FHO surgery?
The type of care depends on the demands of the individual patient, but in general, there are two stages to the post-operative healing process.
Your dog will be recovering from the operation in the first few days after the procedure. Because muscles and bones are severed during this treatment, pain management will be the main concern. Please administer all medications exactly as your veterinarian has instructed. In order to increase comfort and reduce stiffness at this time, moist heat may also be advised.
During the initial few days postoperatively, your veterinarian may advise limiting your activity. If so, keep your dog confined to a kennel or a small area of the house, taking only very brief leash excursions outdoors for bathroom breaks. During this time, you can try passive range-of-motion exercises by gently pushing the hip forward and backward through its range of motion. However, you shouldn’t do this if it hurts your dog.
Slow down as you’re walking so that your dog will put weight on the injured leg.
Around a week after surgery, your veterinarian will probably advise increasing your level of exercise. The emphasis changes to strengthening and regaining muscular mass during this stage of recovery. Keeping your dog active will prevent the fake joint’s scar tissue from adhering too tightly, preserving your dog’s flexibility. Walking (particularly up flights of stairs) is a good exercise during this time, as is holding your dog’s front half in the air while letting them ‘walk’ on their hind legs, and walking through water. In order to urge your dog to carry the injured leg, walking slowly is advised. When running, your dog will be more motivated to do so.
It’s crucial to stay away from rough play and any activities that promotes rapid twists and turns during the first 30 days following surgery. The muscle and joint healing processes will be slowed by these high-impact actions.
About six weeks after surgery, the majority of canines start to exhibit full recovery. Your dog can now get back to his routine activities. When a dog sustains a sudden, traumatic injury to the hip, for example, healing may be quicker than when a dog has long-term, chronic problems because the dog had normal function up until just before the FHO (because these chronic issues often lead to muscle atrophy, which takes time to resolve).
After six weeks following surgery, if your dog has not significantly improved, you might want to think about enrolling him in a structured physical therapy or rehabilitation programme. If your dog is still having issues at or after six weeks, consult your vet for advice.
What is the prognosis after FHO surgery?
After FHO surgery, the afflicted limb functions virtually normally in the majority of canines. Even if the leg’s range of motion or limb length may be somewhat diminished following surgery, these effects are normally minor and have no effect on the pet’s quality of life.
How well does FHO surgery work on dogs?
Total hip replacement surgery is done to provide a pain-free joint with normal biomechanical function in order to enhance the quality of life for a dog who is experiencing hip pain. Treatment options range from conservative medical management to surgical intervention, depending on the issue causing the hip discomfort. A femoral head ostectomy or a total hip replacement (THR) are frequent options provided (FHO).
Over 95% of dogs with total hip replacements should be able to continue an active lifestyle pain-free and without issues for the rest of their lives with today’s technology, prosthesis implants, equipment, and competence. With very few instances, total hip replacement should be suggested as the preferred option over FHO.
Dogs’ legs are reportedly being much more loaded following total hip replacement, according to objective research. The results of published research allow for the following deductions.
- To the author’s knowledge, there is no published literature in a refereed publication that demonstrates objectively how a dog’s rear leg function after an FHO can be compared to that after a THR.
- The FHO surgery always causes significant biomechanical changes to a dog’s hip joint.
- The FHO technique results in varying degrees of limb shortening in dogs.
- After an FHO, pain alleviation can vary.
- After an FHO, recovery takes longer, especially when compared to a THR.
- After an FHO, little dogs and cats may not always recover more favourably than large dogs.
- According to Gendreau and Cawley, “Excellent results after an FHO are somewhat modest (37% excellent and 26% good results).”
- According to some accounts, excellent results may include dogs utilising their legs 75–100% of the time on average (but not always at or near 100% of the time on average). This low percentage of limb function following an FHO is unacceptable given the range of available options.
- To relieve hip pain and restore normal function, a veterinary surgeon will typically advise a total hip replacement. If a total hip replacement cannot be performed, a salvage technique called a femoral head osteotomy is utilised as a last option. A pet owner’s restrictions might make THR operation impossible.
The Femoral Head Ostectomy (FHO) option’s published reports must be compared to Total Hip Replacement (THR) results in order to make decisions. To bolster the aforementioned conclusions, the following is comprehensive information about femoral head ostectomy that has been documented in veterinary literature.
After FHO surgery, may dogs run?
Does your dog have hip issues or conditions? FHO surgery could be suggested as a course of treatment by your veterinarian. Here, our Westport veterinarians describe canine hip anatomy, potential disorders, and the steps needed in FHO surgery and recuperation.
How do hip problems happen in dogs?
Hip issues in dogs can be brought on by trauma, ageing, and heredity. For instance, a genetic condition known as canine hip dysplasia can result in improper hip joint development.
Legg-Perthes disease, which is characterised by a lack of blood flow to the top of the femur, can result in the head of the femur degenerating spontaneously, which can cause arthritis and the collapse of the hip.
Your dog may experience discomfort and mobility concerns as a result of either of these diseases. Surgery on the joints can be required to resolve the problem. We’ll go over how your dog’s hip joint functions, how it can develop disorders that would require surgery to treat them, hip conditions that can be helped by surgery, signs that your dog might be in discomfort, and more in this post.
How does my dog’s hip joint anatomy function?
The hip joint in your dog is comparable to a ball and socket. The femur’s head, or ball, rests inside the acetabulum of the hip bone and is situated at the top of the long thigh bone (which forms the socket part of the joint).
When a dog is healthy, the socket and ball joint work together to allow for pain-free exercise like as running and easy hip motion in all directions. Injury or illness that alters your dog’s typical anatomy might lead to abnormal joint function.
As a result, there may be persistent pain that makes it difficult for them to exercise or go on adventures. This is caused by rubbing and grinding between the ball and socket. Inflammation and diminished mobility are further signs that might lower the quality of life for your pet.
Your dog might require orthopaedic FHO (femoral head ostectomy) surgery to regain pain-free hip movement.
Which hip conditions can benefit from FHO surgery?
FHO surgery can treat a variety of canine hip problems, including:
- Joint displacement (luxation)
- dysplastic hips
- broken hips
- bad arthritis
- Dementia Legg-Perthes
- weak muscles in the legs’ backs
Your dog must weigh less than 50 pounds to be a viable candidate for FHO surgery. In this case, a smaller dog’s weight will be advantageous since the fake joint it creates can support the body more easily than it can with a larger or overweight dog.
Does your dog exceed 50 pounds in weight? If FHO surgery is the best choice, ask your veterinarian.
Which signs of hip pain should I watch for in my dog?
Several symptoms, such as the following, suggest that your dog may be experiencing hip pain:
- rigidity in the joints
- To “bunny hop”
- reduced tolerance for or drive to play or exercise
- Walking with a limp
Your veterinarian is a great resource if any of these symptoms occur since they may be able to identify the problem and suggest a treatment.
What’s involved in an FHO surgery procedure?
To remove the femoral head, a surgeon will perform an FHO procedure. The acetabulum will be left vacant as a result.
Although the femur will initially be held in place by the leg muscles, a “false joint” will eventually form as scar tissue forms between the femur and acetabulum. The tissue between the two locations serves as a cushion. FHO surgery is a reasonably affordable operation.
What are the benefits of FHO surgery?
The head of the femur is removed during FHO surgery, which usually results in the hip becoming mobile again and most dogs being able to move without experiencing any pain.
What should I expect as my dog recovers from FHO surgery?
Your dog may need to stay at the hospital for several hours to several days for post-operative care following surgery. His health, the procedure, and other variables may affect how long he stays.
Following surgery, there are often two phases of recovery:
You and your veterinarian will concentrate on managing pain in the days following surgery with medications such non-steroidal anti-inflammatory drugs, which your veterinarian will prescribe. These will aid in lowering discomfort, edoema, and inflammation at the surgery site.
Following surgery, your dog should refrain from intense exercise for 30 days, and most puppies will require about six weeks to recover. Your dog is permitted to go for brief, leash-free walks while remaining on a leash; nevertheless, he must not run or jump.
Your veterinarian can advise passive range-of-motion exercises to help your dog’s hip joint return to its normal range of motion if he’s not in too much pain.
The second phase of recuperation starts about a week following surgery and entails gradually increasing physical exercise so your dog can grow muscle and strengthen the hip joint.
Additionally, this exercise will increase mobility and stop scar tissue from becoming too stiff. Walking upstairs on your own or having them walk on their back legs while you hold their front legs in the air are both acceptable forms of exercise during this stage. If your dog has recovered sufficiently after the first month, he can resume his usual active activity. However, during the first month of rehabilitation, high-impact activities should still be avoided.
In Phase 2, you and your dog can benefit from using a canine lift harness or mobility device. Due to the amount of muscle mass surrounding the hip joint, pets who were relatively active before surgery typically heal more quickly.
Depending on the specific conditions and demands of your dog, several levels of care may be necessary. If it takes longer than the customary six weeks for your dog to recover totally, he might require specialised physical therapy. Contact your veterinarian if your pet appears to be in a lot of discomfort or is not recovering well at any stage after surgery.
What should I ask my vet about FHO surgery?
- Can you recommend a veterinary surgeon to me if you are unable to do this surgery?
- Do you think my dog would benefit from having FHO surgery?
- Would you be able to suggest a facility if physical therapy or rehabilitation are required after surgery?
Please take note that the information in this page is for informational purposes only and does not constitute medical advice for animals. Please schedule an appointment with your veterinarian for a precise diagnosis of your pet’s illness.
Is your dog experiencing hip pain? Contact our Westport veterinary team to schedule a consultation. Diagnostics are part of our services.
Since 1993, Westport’s Poster Veterinary Associates has offered complete veterinary care for your beloved pets.