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Alternatives to FHO Surgery for Dogs

Alternatives to FHO Surgery for Dogs

Femoral Head Ostectomy

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Owners

Explore the best alternatives to FHO surgery for dogs, including THR, TPO, JPS, and non-surgical options like rehab, supplements, and pain management

By 

Sustainable Vet Group

Updated on

July 28, 2025

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Alternatives to FHO Surgery for Dogs

When Is FHO Recommended—and Why Look for Alternatives?

FHO is often used to treat hip dysplasia or joint damage when the hip causes constant pain. It removes the ball part of the hip joint, stopping bone-on-bone contact and letting a soft false joint form. This surgery is safe for small to medium dogs and offers good pain relief when done at the right time.

Still, FHO isn’t the only path. Some dogs may benefit from less invasive care before trying surgery. Owners often explore alternatives when:

  • The dog has mild or early-stage hip dysplasia
  • Surgery costs or recovery time are a concern
  • The dog is large or still growing, making FHO less ideal
  • The owner wants to try physical therapy or medicine first

Trying other options first can delay or even avoid surgery. It also gives more time to track your dog’s progress and comfort. Always discuss the full picture with your vet before making a final decision.

Surgical Alternatives to FHO

While FHO is a good option for many dogs, other surgical choices may offer better results depending on your dog’s age, hip condition, and long-term needs.

1. Total Hip Replacement (THR)

Total Hip Replacement replaces the entire hip joint with a metal and plastic implant. It’s often the best choice for adult dogs with severe hip dysplasia or arthritis. THR restores natural joint movement and gives the closest result to a healthy hip.

This procedure offers:

  • Excellent pain relief and function
  • Full range of motion in most dogs
  • High success rates in healthy adults

However, it’s also the most complex and expensive option. It requires a specialist surgeon and a longer recovery period. THR is not often done in young puppies or dogs with other health concerns. But when done at the right time, it can give lasting comfort and active mobility for years.

2. Triple Pelvic Osteotomy (TPO)

TPO is a surgery used in young puppies before arthritis sets in. It works by cutting and rotating parts of the pelvis to improve how the ball fits in the hip socket. This gives more stability and reduces the chances of dysplasia getting worse.

TPO is best when:

  • The puppy is under 10 months old
  • There is no joint damage or arthritis
  • A PennHIP screening shows joint looseness early

TPO must be done early, before pain or damage begins. It allows the joint to grow in a better position, preventing problems later in life. Although more invasive than other preventive methods, TPO offers a strong, lasting solution for dogs caught early.

3. Juvenile Pubic Symphysiodesis (JPS)

JPS is a preventive surgery used in very young puppies to reduce the risk of hip dysplasia. It works by fusing a small part of the pelvic bone, which causes the rest of the pelvis to grow in a way that tightens the hip joint.

JPS is ideal when:

  • The puppy is under 5 months old
  • There are early signs of hip looseness
  • The owner wants to prevent future joint issues

This surgery is simple, low-cost, and highly effective when done at the right age. It does not remove any bones or parts of the joint. Instead, it improves how the joint forms as the puppy grows. JPS is a smart choice when dysplasia is caught early through screening tools like PennHIP.

4. Capsular Neurectomy

Capsular neurectomy is a lesser-known surgery that helps manage hip pain by cutting nerves around the joint. It doesn’t fix joint shape but blocks the pain signals coming from the hip capsule.

This option may be useful when:

  • The dog has mild to moderate hip pain
  • Surgery like FHO or THR is not possible right away
  • The goal is to delay more invasive procedures

Although less common, this surgery can offer relief in selected cases, especially when cost or timing is a concern. It doesn’t change the joint but may reduce discomfort enough to improve walking and daily comfort. Some vets may use it as a temporary or supportive step before larger surgeries.

Non-Surgical Alternatives to FHO

For dogs with mild or early-stage hip dysplasia, non-surgical care can reduce pain and improve mobility. These options work best when started early and followed consistently. They aim to support the joint, reduce inflammation, and prevent further damage. While they don’t fix the joint’s structure, they can slow the progression of dysplasia and help your dog stay active and comfortable without surgery.

1. Weight Management and Lifestyle Changes

Extra weight puts added pressure on painful hips, so even a small weight loss can make a big difference. Reducing body weight by just 5–10% lowers joint stress and helps your dog move more comfortably.

Helpful lifestyle changes include:

  • Controlled low-impact exercises like walking or swimming
  • Avoiding stairs and slippery floors
  • Using ramps instead of jumping into cars or onto beds

Daily routines that support the hips can reduce pain and delay the need for surgery. Talk to your vet about feeding plans and exercise goals tailored to your dog’s needs.

2. Physical Therapy and Hydrotherapy

Physical therapy helps dogs with hip dysplasia move better and build strength without damaging the joint. It focuses on keeping muscles strong, joints flexible, and movement pain-free. Hydrotherapy is especially useful, as it supports the body while reducing weight on the hips.

Key therapies include:

  • Underwater treadmill work for low-impact strengthening
  • Massage and stretching to improve range of motion
  • Balance exercises and guided movement drills

These sessions are best done with a trained rehab therapist, but simple home exercises also help. Regular therapy sessions over several weeks or months can greatly improve comfort and mobility.

3. Pain Management and Supplements

Pain control is key for dogs with hip dysplasia, especially in early stages or when surgery is not an option. Medications and natural supplements can help reduce inflammation, ease discomfort, and improve daily life.

Common options include:

  • NSAIDs or gabapentin for pain relief
  • Injectable joint support like Adequan
  • Supplements with glucosamine, chondroitin, or omega-3s

Alternative therapies like laser therapy or acupuncture may also support pain control. These treatments don’t fix the joint, but they can help manage pain and keep your dog more active. Always check with your vet before starting or combining treatments.

How to Choose the Right Alternative for Your Dog

Picking the best option for your dog involves more than just looking at the hip problem. You also need to think about your dog’s age, size, how active they are, and your ability to manage long-term care. Talking to your vet is key, but understanding the main factors can help you ask better questions and feel more confident about the path you choose.

Factors That Influence the Choice

Each dog is different, so treatment should match their specific needs. The main things to think about include:

  • Age and growth stage – Younger puppies may qualify for preventive options like JPS
  • Size and weight – Smaller dogs adapt better to surgeries like FHO
  • Joint health – Dogs with arthritis need a different plan than those in early stages
  • Energy level – Active dogs may need a stronger joint solution
  • Budget and rehab – Some surgeries are costly and require long recovery care

These details help you and your vet choose what’s safe, affordable, and effective for your dog.

Decision Matrix: Which Option Fits Best

Here’s a simple guide to match your dog’s situation with the most suitable treatment:

  • Juvenile Pubic Symphysiodesis (JPS) → For puppies younger than 5 months with no joint damage
  • Triple Pelvic Osteotomy (TPO) → For puppies under 10 months with healthy joints but loose hips
  • Total Hip Replacement (THR) → For adult dogs with severe pain and no major health problems
  • Femoral Head Ostectomy (FHO) → For small to medium dogs or as a backup when THR isn’t possible
  • Non-surgical options → For dogs in early stages, or when surgery isn’t a good fit

Always confirm with your vet before making any final decision. Timing, health status, and your long-term support will guide the best path forward.

What to Try Before Choosing Surgery

Before deciding on surgery, it’s smart to try conservative care options—especially if your dog’s hip dysplasia is mild or in the early stages. These steps can help reduce pain, improve movement, and possibly delay or avoid surgery altogether.

Here are key actions to take:

  • Start with structured weight loss to reduce strain on the hips
  • Add joint supplements like glucosamine and omega-3s for 4–6 weeks
  • Begin physical therapy or hydrotherapy to build strength and flexibility
  • Try pain relief meds such as NSAIDs or gabapentin and monitor response
  • Watch closely for changes in mobility, playfulness, and comfort

These steps give your vet a clearer picture of what’s working. In many cases, dogs improve enough to avoid surgery in the short term. If your dog still struggles after these trials, surgery may be the better long-term solution. Always track changes and check in with your vet regularly.

When FHO Might Still Be the Best Option

Despite the range of alternatives, FHO still plays an important role in treating certain hip problems. It becomes the best option when non-surgical methods no longer provide relief and daily pain limits your dog’s ability to walk, rest, or play. While more advanced surgeries like THR or TPO may offer stronger outcomes, they are not always possible due to cost, age, or limited access to skilled surgeons.

FHO is especially valuable for:

  • Dogs under 50 pounds, where false joints form more easily
  • Older dogs who can’t undergo complex surgeries
  • Cases involving fractures, implant failures, or avascular necrosis
  • Owners needing a lower-cost but effective option

When chosen carefully and followed by good rehab, FHO can still provide excellent results. It doesn’t restore a normal joint, but it does remove the source of pain. For the right dog, it offers lasting comfort and a return to a more active, happy life.

Final Thoughts: Choosing the Right Path

When facing hip dysplasia in your dog, it’s natural to feel unsure about the best treatment. Whether you’re considering FHO, another surgery, or non-surgical care, the right choice depends on more than just X-rays. Your dog’s age, size, activity level, and overall health all matter. So does your ability to manage rehab, follow-up care, and long-term support.

There’s no single solution that fits every dog. Some may thrive with supplements and therapy, while others need surgery to stay pain-free. That’s why working closely with your vet is so important. Together, you can review all the options and create a plan that fits your dog’s specific needs and your lifestyle.

With the right guidance and care, many dogs live full, active lives—even with hip dysplasia. The goal is comfort, movement, and a happy future, no matter which path you choose.

FAQs About Alternatives to FHO Surgery in Dogs

Can hip dysplasia be managed without surgery?

Yes, mild to moderate hip dysplasia can often be managed without surgery using a mix of weight control, physical therapy, pain medications, and joint supplements. These steps reduce pain and support movement. While they don’t fix the joint, they can delay the need for surgery and improve quality of life, especially in early-stage cases.

What is the best non-surgical treatment for hip dysplasia?

The best non-surgical approach often combines several therapies: a lean diet, low-impact exercise like swimming, joint supplements (glucosamine and omega-3s), and prescribed pain relief medications. This plan helps reduce inflammation, strengthen muscles, and support better joint function. Results vary, so regular vet check-ins are important to monitor your dog’s progress and adjust care as needed.

Is Total Hip Replacement better than FHO?

Total Hip Replacement (THR) offers a more natural joint function and long-term outcome than FHO, especially in large or active dogs. However, THR is more expensive, complex, and not ideal for all dogs. FHO is still a good option for smaller dogs, older pets, or cases where THR isn’t possible due to cost or health concerns.

What is JPS and when should it be done?

Juvenile Pubic Symphysiodesis (JPS) is a preventive surgery done in puppies younger than 5 months old. It helps the hip socket form better by changing how the pelvis grows. When done early, JPS can reduce or prevent future signs of hip dysplasia. It’s low-risk and cost-effective but must be done before joint damage begins.

Can physical therapy help avoid hip surgery?

Yes, physical therapy can often delay or reduce the need for surgery. It builds muscle to support the joint, improves flexibility, and helps dogs move with less pain. When combined with other treatments like medication and weight control, therapy may keep your dog active and comfortable without surgical intervention—especially in early-stage dysplasia.

What if my dog is too young or too old for surgery?

For very young puppies, early procedures like JPS or TPO may be possible. If the puppy is too young for major surgery, conservative care can manage symptoms until they’re ready. Older dogs who can’t undergo complex surgery may still benefit from FHO or non-surgical care focused on comfort, mobility, and pain control. Always ask your vet for age-specific options.

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