FHO (Femoral Head and Neck Ostectomy) Starting at $2000
A femoral head osteotomy, also referred to as a femoral head and neck ostectomy or FHO, is the surgical removal of the head and neck of the femur. In simpler terms, it is 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 dog with hip dysplasia or severe osteoarthritis. This procedure is usually used as a last resort or salvage procedure in dogs with severe hip dysplasia that are not candidates for a total hip replacement. It is also used to treat dogs with Legg-Calve-Perthes disease. Once the femoral head and neck are removed, the surrounding muscles and developing scar tissue work to support the area and act as a false joint. This means that now when the dog moves its limb, forces transfer to the pelvis rather than to the leg itself. FHO surgery is a simple procedure that requires minimal equipment and does not need implants. The procedure causes the leg to be slightly shorter than the unaffected leg, although amazingly, most dogs return to close to normal activity after the surgery.
In many cases, the goal of the FHO procedure is to relieve pain associated with hip dysplasia rather than to create a joint with completely normal function. Therefore, while there are no specific weight guidelines for the use of a femoral head and neck ostectomy, smaller dogs typically have a better outcome since less stress and force are carried on the false joint than would be in a large breed dog. That being said, this procedure may be indicated in large and giant-breed dogs in which other treatments have been ineffective or are not feasible, and can dramatically improve the quality of life in dogs with painful arthritic hips. Additionally, the best results are usually attained when done after the animal is skeletally mature and has finished growing.
FHO surgery will relieve the pain that is caused by hip dysplasia, and you may notice that your dog seems to feel better rather quickly. However, it is important to note that following FHO surgery, your dog may always have some degree of lameness even after proper rehabilitation. This does not mean the surgery has failed but rather that your dog is no longer working with a correctly formed joint—a false joint and a slightly shortened leg changed the dynamics of the hip. Although some degree of lameness may still be present, it will most likely be a huge improvement over the dog’s gait prior to the surgery.
As previously mentioned, FHO surgery for dogs is often considered in cases when a total hip replacement is not feasible. FHO as a treatment for hip dysplasia is generally performed in mature dogs. When it comes to hip surgery, the size, weight, and age of the dog are very important factors in deciding how to proceed. Most general practitioners can perform an FHO, meaning that referral to an orthopedic surgeon may be unnecessary. FHO for dogs is a preferable option for the treatment of hip dysplasia when finances are a major concern.
Despite the lack of a normal hip joint following FHO surgery for dogs, most do surprisingly well after the procedure. Results can vary depending on the patient’s size and post-operative rehabilitation. Unlike many other orthopedic surgeries, with an FHO, the dog should be encouraged to use the leg immediately post-op in a controlled manner. This is important because the dog now relies on the surrounding musculature to support the hip; if the dog is not weight-bearing, resulting in muscle atrophy and shortening will greatly increase the time of recovery and decrease the chances of a desirable return to function. According to Michigan State University, dogs having FHO surgery will usually toe-touch in about 10-14 days and partially bear weight in three weeks. Usually, they are actively using the limb in one month, but it can take up to six months before complete using healing and function are evident.
Every surgery comes with a risk of complications. With FHO surgery, the most common complications encountered are decreased range of motion and mobility in the leg, muscle atrophy, loss of function, and infection. However, with aggressive post-operative rehabilitation under the guidance of your veterinarian and/or rehabilitation therapist, the chance of these complications is greatly reduced, and most owners are happy with the outcome of the surgery.