Femoral Head and Neck Ostectomy (FHO)

What is a femoral head and neck ostectomy?

The hip is a ball and socket joint, with the femoral head (the upper part of the leg) being the ball and the acetabulum (a portion of the pelvis) comprising the socket. Femoral head and neck ostectomy (FHO) is a surgical procedure in which the ball portion and the attachment (neck) portion are removed from the rest of the femur, which in essence removes the hip joint. The body forms a “new hip” in the months following surgery. But unlike the normal contact of bone and cartilage, the new hip is a collection of scar tissue with additional support from the surrounding muscles and joint capsule.

FHO is a surgical treatment for hip disorders such as a fractured hip, hip dysplasia, hip luxation, and Legg-Calve-Perthes disease in small dogs (less than 50 pounds) and cats.

What is the post-operative care?

In contrast to many other orthopedic surgeries, early use of the leg after surgery is important to allow for the best possible outcome. In many pets, this will require owners to perform physical therapy, utilizing techniques such as range of motion exercises and swimming. Physical therapy is started as soon as pets will allow, usually after suture removal, seven to 10 days post-surgery.

Are pets able to walk normally on the leg after surgery?

Femoral head and neck ostectomy (FHO) is an excellent treatment to eliminate hip pain. However, because the natural hip is gone, the leg may not be as strong as a normal leg. This decrease in strength is difficult or impossible to notice in cats and small dogs but it may be more obvious in large- and giant-breed dogs. Small dogs and cats usually have an excellent outcome after FHO, whereas larger breeds will keep a distinct gait difference.

What are the risks or complications?

There are few risks or complications with this surgery. Be sure to discuss them at your appointment with your surgeon. All pets must have current, pertinent blood work in order to assess the risk for general anesthesia. The risk is usually very low for healthy animals with normal blood work. It is further reduced by local pain control during anesthesia, which is accomplished by epidural anesthesia.

Overall, some pets recover very quickly with little need for owners' assistance, but other animals need intensive physical therapy. Lean and fit animals tend to recover more quickly than overweight and weaker pets.