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Pros and Cons of Femoral Head Ostectomy in Dogs

Pros and Cons of Femoral Head Ostectomy in Dogs

Femoral Head Ostectomy

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Owners

Explore the pros and cons of femoral head ostectomy in dogs. Learn benefits, risks, and if FHO is the right choice for your pet's hip condition

By 

Sustainable Vet Group

Updated on

July 28, 2025

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Pros and Cons of Femoral Head Ostectomy in Dogs

What Is Femoral Head Ostectomy (FHO)?

Femoral Head Ostectomy (FHO) is a surgical procedure used to treat painful hip conditions in dogs. It involves removing the head and neck of the femur—the ball part of the hip joint. This helps eliminate bone-on-bone contact, which is often the main cause of pain in dogs with hip dysplasia, arthritis, or joint injuries.

After the surgery, the body forms a false joint made of scar tissue. While this joint doesn’t function like a natural one, it often allows dogs to move comfortably without pain. FHO is most commonly used in small to medium-sized dogs or those who cannot undergo more complex surgeries like total hip replacement. It offers a simpler and more affordable option to restore comfort and mobility.

With proper recovery care, dogs can return to walking, playing, and enjoying life again after FHO.

Is FHO Right for Your Dog?

Femoral Head Ostectomy (FHO) can be a highly effective surgery, but it’s not right for every dog. Your vet will help you decide based on your dog’s size, overall health, personality, and your ability to manage recovery at home. To make a confident decision, it’s helpful to know which dogs benefit most—and when FHO might not be the best fit. The following points can guide your thinking before moving forward.

Ideal Candidates for FHO

FHO is best suited for small to medium-sized dogs, especially those under 50 pounds. These dogs place less pressure on the healing hip and often adapt well to the false joint that forms after surgery. Dogs living with long-term hip pain or non-repairable fractures are common candidates. If your dog still enjoys moving around and responds well to food rewards, they are more likely to participate in rehab exercises.

  • Dogs under 50 lbs or low body weight
  • Hip dysplasia, arthritis, or injury unresponsive to meds
  • Curious, motivated behavior that supports rehab
  • Owners able to handle structured, daily recovery

When these conditions are met, FHO can bring long-term comfort and strong mobility gains.

When to Reconsider

FHO may not be the best option for every dog. Large or overweight dogs tend to put more pressure on the healing joint, making recovery slower and more difficult. If your dog already struggles with severe arthritis in other joints or has spinal problems, they may not gain full function from the surgery. Inactive dogs or those who resist movement may also avoid using the leg, leading to stiffness or poor results.

Families who cannot commit to daily rehab should also reconsider. FHO recovery requires regular walks, home exercises, and follow-up appointments. Skipping these steps can limit the benefits of surgery.

  • Dogs over 50 lbs or with excess body weight
  • Severe arthritis, back problems, or multiple joint issues
  • Dogs that are anxious, fearful, or resistant to touch
  • Owners unable to provide consistent rehab or follow-ups

In these cases, your vet may suggest medical management, assistive devices, or alternative surgeries that better suit your dog’s needs.

Pros of Femoral Head Ostectomy

Femoral Head Ostectomy (FHO) offers several clear benefits, especially for dogs that cannot undergo total hip replacement. One of the biggest advantages is pain relief. By removing the femoral head, the source of bone-on-bone contact is eliminated, making daily movement more comfortable. Dogs often regain mobility and return to normal activities after recovery.

  • Provides long-term relief from hip pain
  • Costs significantly less than total hip replacement
  • No implants means fewer surgical complications
  • Shorter surgery time reduces anesthesia risks
  • Works well for senior dogs in stable health
  • Often removes the need for daily pain medication
  • Ideal for dogs who aren’t good candidates for THR

FHO is especially helpful for small to medium-sized dogs and those with financial or medical limitations. With proper post-op care, many dogs experience a major improvement in quality of life, even if their gait isn’t perfect. It’s a trusted, low-risk option for managing hip problems in many pets.

Cons of Femoral Head Ostectomy

While FHO can offer pain relief and improved comfort, there are some important considerations to keep in mind. The procedure does not recreate a natural hip joint, so some dogs may have a permanent limp or an altered gait. This is often mechanical and not painful, but it may be noticeable during fast movements or long walks.

  • Some dogs retain a mild limp after healing
  • Limited hip range of motion compared to a natural joint
  • Muscle loss can occur without consistent rehab
  • Recovery takes time—typically 3 to 6 months
  • Outcomes vary depending on dog size and behavior
  • May be less effective in large or anxious dogs
  • Not ideal for dogs that need full athletic function

FHO focuses on comfort, not perfection. It may not be the best fit for highly active dogs or working breeds that require full strength. Still, for many pets, it provides a safe and lasting solution to chronic hip pain.

How FHO Compares to Other Options

FHO is one of several treatments available for hip problems in dogs. Here’s how it stacks up against other common choices.

FHO vs Total Hip Replacement (THR)

Total Hip Replacement (THR) provides a more natural joint movement by replacing the entire hip with a prosthetic implant. It offers the best mechanical outcome, especially for large or highly active dogs. However, THR is expensive, has a longer recovery period, and carries higher surgical risks—particularly in senior dogs or those with other health conditions.

FHO, on the other hand, is simpler and safer. It removes the femoral head, allowing a fibrous joint to form. This reduces pain without needing an implant. Dogs need stronger muscle support around the joint to regain function.

  • THR offers better joint mechanics
  • FHO has lower cost and fewer complications
  • FHO relies on muscle compensation post-op

FHO is often preferred when THR isn’t feasible or safe for the dog’s size, age, or health.

FHO vs Conservative Management

Conservative management usually includes pain medications, joint supplements, weight control, and limited activity. While this may help in the early stages of joint disease, it doesn’t stop the underlying bone damage. Over time, medications may become less effective, and side effects can occur with long-term use.

FHO offers a surgical solution by removing the painful joint structure. After recovery, many dogs need fewer or no pain medications at all. Both options require rehab, but FHO has the added benefit of removing the bone-on-bone contact that causes the pain in the first place.

  • Medications only manage symptoms
  • FHO addresses the pain source directly
  • Rehab is needed for both, but FHO adds structural relief

For dogs not responding well to medications, FHO may offer a better long-term outcome with proper post-op care.

What Determines Success After FHO?

The surgery alone isn’t enough—recovery depends on your dog and your effort.

The success of Femoral Head Ostectomy isn’t just about what happens in the operating room. What comes next plays an even bigger role. A dog’s condition before surgery makes a difference. Dogs with better muscle tone and fewer other joint problems tend to recover faster. Just as important is the owner’s role in managing daily rehab routines.

  • Pre-surgery muscle strength supports faster recovery
  • Owners must stay consistent with walks, exercises, and vet follow-ups
  • A safe home setup helps avoid injury and builds confidence
  • Motivated, active dogs usually engage better in rehab
  • Tools like hydrotherapy, PROM, and massage boost progress

The personality of your dog also matters. Curious and food-motivated dogs often do better than fearful or passive ones. And when the home environment supports safe movement—like with non-slip mats, ramps, or blocked stairs—dogs feel more confident using the leg. When both dog and owner stay committed, the chances of a successful outcome are very high.

Common Questions to Ask Your Vet Before Choosing FHO

Before moving forward with Femoral Head Ostectomy, it’s important to have a clear conversation with your vet. Asking the right questions will help you understand whether FHO is the best fit for your dog’s condition, lifestyle, and long-term health. This is especially important for senior dogs or those with other medical concerns.

  • Will my dog benefit more from FHO or Total Hip Replacement (THR)?
  • Is my dog healthy enough to safely go under anesthesia?
  • Am I prepared to manage daily rehab for 3 to 6 months?
  • What is the realistic chance of long-term pain relief in my dog’s case?

These questions can help you weigh the benefits and limitations of surgery, rehab commitment, and overall recovery expectations. Your vet may also offer insights based on breed, age, weight, and behavior. A well-informed choice gives your dog the best chance at a comfortable, active life after surgery.

Final Thoughts: Should You Choose FHO?

Femoral Head Ostectomy (FHO) is a well-established surgery for managing chronic hip pain in dogs. It may not fully restore a normal gait, but it often gives lasting pain relief and improved mobility—especially in small to medium dogs or those who aren’t candidates for total hip replacement. The success of FHO depends on more than just the surgery. Your dog’s pre-surgery health, attitude toward movement, and your ability to follow a rehab plan all influence recovery.

  • Best suited for dogs under 50 pounds
  • Requires daily rehab and home adjustments
  • Offers a safe, lower-cost alternative to complex surgeries
  • Long-term comfort often improves with commitment and care

Discuss all options with your vet, including your ability to manage recovery. If the match is right, FHO can help your dog return to a more active, pain-free life—without relying on long-term medications or invasive implants.

FAQs About FHO Pros and Cons in Dogs

Is FHO a permanent solution for hip problems in dogs?

Yes, FHO is considered a permanent procedure. It removes the femoral head to eliminate pain, and a false joint forms over time. While it may not restore perfect motion, it often provides long-term relief and improved comfort for dogs who are good candidates.

Will my dog still walk normally after FHO surgery?

Many dogs walk well after recovery, though some may have a mild, mechanical limp. This limp is usually painless and doesn’t affect daily life. With proper rehab and weight control, most dogs regain good function and enjoy normal activities.

What are the main risks of FHO surgery?

The main risks include infection, slow healing, or a persistent limp if rehab is skipped. Large or overweight dogs may have more difficulty using the leg post-op. However, serious complications are rare when surgery and recovery are well managed.

How does FHO compare to total hip replacement?

FHO is less invasive, less costly, and has fewer complications than total hip replacement. While THR provides better joint mechanics, FHO offers effective pain relief for many dogs—especially those not suited for a full implant surgery.

Is FHO better than long-term medication?

FHO often reduces or removes the need for long-term pain medication. While meds may help manage early-stage joint issues, FHO addresses the root cause. This can improve comfort while avoiding the side effects of daily drug use in senior dogs.

Can FHO be done on both hips?

Yes, FHO can be done on both hips if needed, though not always at the same time. If both hips are painful, vets may suggest staged surgeries with time for healing in between. With careful rehab, dogs can adapt well to bilateral FHO.

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