Blog
 » 
Femoral Head Ostectomy
 » 
Common Complications After FHO Surgery in Dogs

Common Complications After FHO Surgery in Dogs

Femoral Head Ostectomy

X min read

Owners

Learn about common FHO surgery complications in dogs, including limp, infection, and recovery issues—plus tips to spot and manage them early

By 

Sustainable Vet Group

Updated on

July 29, 2025

.

Common Complications After FHO Surgery in Dogs

Understanding FHO Recovery and Risk

Femoral Head Ostectomy (FHO) is a surgery where the ball of the hip joint is removed to reduce pain and restore mobility. Instead of a normal joint, the body creates a false joint made of muscle and scar tissue. Most dogs recover well with time, care, and rehab. But like any surgery, complications can still happen.

Knowing the risks helps you spot problems early and support better recovery. Most issues are minor and treatable if caught on time. A few may require extra rehab or follow-up care.

  • FHO removes the femoral head to relieve hip pain
  • The body forms a pseudo-joint that allows movement
  • Complications are uncommon but can affect recovery
  • Risks increase if rehab or weight is not managed well

Setting realistic expectations prepares you better. With good care, your dog can still enjoy a pain-free, active life—even if small bumps happen along the way.

Surgical Site Complications

Infection and Wound Issues

Infection is one of the more serious but rare complications after FHO. It often starts at the incision site and can slow healing or lead to pain. Watch the surgical area closely in the first two weeks. Even small changes can signal a problem. Most infections are treatable when caught early.

  • Signs include redness, swelling, heat, or thick discharge
  • A foul odor or yellow/green pus may be present
  • Fever, shaking, or lack of appetite are warning signs
  • Excessive licking or chewing can lead to infection

Call your vet if you notice any of these signs. Don’t wait, even if symptoms seem small. Treatment usually includes antibiotics and wound cleaning. Severe cases may require a flush or surgical revision. Keeping the incision clean, dry, and protected with an E-collar helps prevent infection and supports faster healing.

Seroma (Fluid Build-Up)

A seroma is a pocket of clear fluid that sometimes forms under the incision after surgery. It can look like a soft lump and may feel squishy to the touch. Seromas are not dangerous in most cases, and they often go away on their own within a few weeks. However, it's important to monitor them closely.

  • Appears as a soft, non-painful bulge near the incision
  • Fluid is usually clear and does not leak out
  • Common after activity, slipping, or licking the area
  • No fever, redness, or foul smell if it’s harmless

If the lump grows, becomes red, painful, or starts draining, call your vet. In some cases, the fluid may need to be drained. Limiting movement and preventing licking reduces the risk. Seromas are typically mild and don’t require emergency care, but watching for changes helps ensure it stays that way.

Mobility and Limb Use Complications

Delayed Toe-Touching or Weight-Bearing

After FHO surgery, most dogs begin toe-touching within 3–5 days and start putting weight on the leg by 10–14 days. Delays can happen, especially in nervous or overweight dogs, but it’s important to support gentle movement. If your dog still refuses to touch the foot down by week three, it may signal discomfort or lack of muscle strength.

  • Toe-touching is expected within the first week
  • Weight-bearing often starts by the second week
  • Use sling support for gentle movement during potty breaks
  • Place traction mats on slippery floors to reduce fear

You can encourage early movement by keeping walks short and positive, using rewards, and doing passive range-of-motion exercises. If there's no progress or the dog drags the leg, call your vet or rehab therapist. Early motion helps prevent long-term issues like stiffness or disuse.

Chronic or Recurring Lameness

Some dogs develop long-term lameness after FHO if the muscles don’t rebuild properly. Chronic limping often comes from weak hip support, delayed rehab, or ongoing joint inflammation. While a slight limp is common, recurring or worsening lameness needs attention. Early rehab makes a big difference in preventing this issue.

  • Weak or tight muscles can limit joint support
  • Skipping rehab leads to loss of strength or imbalance
  • Pain may return with weight gain or overuse
  • Watch for limping that returns after rest or exercise

Your vet may suggest more physical therapy, anti-inflammatory meds, or further testing if limping continues beyond 8–10 weeks. Stick to consistent rehab and avoid high-impact play until your vet clears it. Many dogs improve with time and patience, but chronic lameness can become harder to fix if ignored.

Permanent Limp or Gait Changes

It’s common for dogs to have a slight limp or different gait after FHO. This “mechanical limp” is not painful—it just reflects changes in how the leg moves without the original joint. The leg may swing differently or feel a bit stiff. Most dogs adapt well and don’t show signs of pain.

  • Mild limp or shorter stride is expected in many dogs
  • Often more visible at slow walks or when tired
  • Doesn’t affect play or comfort in most cases
  • No signs of pain, swelling, or limping after activity

If the limp is getting worse, or your dog avoids using the leg completely, that’s a warning sign. Some limps need more rehab or pain support. But in many cases, a permanent limp is just a sign of how the body adapted. As long as your dog is active and happy, it’s usually not a cause for concern.

Leg Length Discrepancy

After FHO surgery, the operated leg may seem slightly shorter. This happens because removing the femoral head removes part of the bone's length. The difference is usually small, but it can affect balance, posture, and how your dog moves. Most dogs adjust over time and build muscle to compensate.

  • Leg may appear shorter when standing or walking
  • Common in dogs with muscle loss or slow rehab
  • Can lead to mild head bobbing or uneven steps
  • Watch for signs of back or opposite leg strain

Weight management and regular rehab help improve alignment and reduce stress on other joints. If the length difference seems to worsen, or your dog shifts weight off that leg often, ask your vet for a follow-up exam. In many cases, the body adapts without issue—but monitoring posture and balance is still important long term.

Reduced Hip Range of Motion

A drop in hip flexibility after FHO is common, especially if rehab is delayed. Scar tissue forms naturally around the surgery site, and without regular movement, the muscles and soft tissues tighten. This limits how far your dog can extend or flex the hip, which may cause stiff walking or uneven sitting.

  • Scar tissue builds up without movement
  • Inactivity or crate rest beyond 2 weeks worsens stiffness
  • Passive range-of-motion (PROM) helps maintain flexibility
  • Massage and warm compress can relax tight muscles

To improve motion, begin PROM exercises early (as your vet recommends) and stick with rehab for at least 6–8 weeks. Hydrotherapy or walking uphill can also stretch and strengthen the hip joint gently. If range of motion stays limited after recovery, your vet may refer you to a rehab specialist for a custom exercise plan.

Muscle and Nerve-Related Complications

Muscle Atrophy in Operated Leg

Muscle atrophy means loss of muscle mass and strength. After FHO surgery, dogs often rest for several weeks, which leads to reduced use of the operated leg. This lack of movement causes the muscles in that leg to shrink and weaken. While this is expected early on, it must be reversed with regular rehab.

Rebuilding muscle is key to long-term success after FHO. A strong hip and thigh area helps the body form a stable pseudo-joint and supports better movement.

  • Happens due to rest and reduced limb use
  • Common in dogs with delayed weight-bearing
  • Weak muscles slow down progress in rehab
  • Can be improved with daily walking and targeted exercises

Start gentle leash walks, passive motion exercises, and strength training under your vet’s guidance. Over time, the muscle will return, and the leg will regain better function. Skipping rehab may lead to permanent weakness or long-term limping.

Sciatic Nerve Damage

Sciatic nerve damage is a rare but serious complication of FHO surgery. The sciatic nerve runs near the hip, and although surgeons work carefully to protect it, injury can occur due to inflammation, swelling, or surgical trauma. When the nerve is affected, your dog may show signs of pain, weakness, or trouble using the leg.

This condition can affect recovery and needs quick medical attention.

  • Signs include foot dragging, weak paw placement, or knuckling
  • Some dogs may cry out or avoid walking
  • May cause one leg to cross under or feel limp
  • Recovery depends on severity and early treatment

If you notice nerve-related symptoms, contact your vet immediately. Nerve damage may improve with anti-inflammatory meds, rest, and rehab, but in some cases, it may require long-term management. Regular follow-ups and early detection are key to reducing long-term impact from sciatic nerve issues.

Pain-Related and Structural Complications

Bone-on-Bone Contact

Bone-on-bone contact happens when the femoral head is not fully removed during FHO surgery. This leftover bone may still rub against the hip socket, causing pain, stiffness, and limping. While rare, it’s a serious issue that can limit your dog’s recovery and comfort. Most vets take great care to remove the entire femoral head, but small remnants can be missed.

This complication often shows up as slow or painful movement weeks after surgery.

  • Caused by incomplete removal of the femoral head and neck
  • Leads to painful grinding or joint stiffness
  • Dog may avoid using the leg or limp after activity
  • Confirmed by follow-up X-rays or CT scans

If your dog shows signs of pain or limited progress, your vet may recommend imaging. In some cases, a second surgery is needed to remove remaining bone. Proper surgical technique and early rehab help lower this risk significantly.

Fibrous Scar Tissue Formation

After FHO surgery, the body naturally forms fibrous scar tissue to help create a pseudo-joint. While this process is important for stability, too much scar tissue or poor rehab can lead to joint tightness. This stiffness may cause reduced hip motion, uneven gait, or discomfort during movement.

Rehab plays a key role in keeping the joint mobile and stopping excessive tissue buildup.

  • Forms naturally after surgery as part of healing
  • Too much can limit range of motion or cause stiffness
  • More common in dogs with delayed rehab or long crate rest
  • Can affect walking, stretching, and overall joint use

Daily range-of-motion exercises, gentle walking, and hydrotherapy all help reduce excess scar tissue. The earlier you start safe rehab, the better the joint stays flexible. If the hip remains tight after 8–10 weeks, your vet or rehab therapist may adjust the plan to improve mobility.

Behavioral and Psychological Effects

Recovery isn’t just physical—your dog’s emotions and behavior can change after surgery, and it’s important to support their mental well-being too.

Fear or Reluctance to Use the Leg

Even after healing begins, some dogs may avoid using the operated leg due to fear or past pain. This is called learned non-use. It’s not always a sign of injury—it’s often just hesitation. Your dog may remember the discomfort and choose to keep the leg lifted even if it’s safe to walk.

  • Normal behavior in the early weeks of recovery
  • Caused by fear of pain, slipping, or instability
  • Reward gentle steps or toe touches with praise and treats
  • Use short walks and rehab games to build confidence

Never force movement. Instead, use calm encouragement and consistent routine. With time and trust, most dogs begin to use the leg again naturally. If fear continues after 4–6 weeks, consult your vet or a canine rehab therapist for guidance.

Anxiety or Clinginess Post-Surgery

Some dogs become anxious or overly attached after FHO surgery. This can come from pain, the effects of anesthesia, or the change in daily routine. You may notice whining, restlessness, or following you constantly. These behaviors are common and usually temporary, but they still need gentle management.

  • Caused by confusion, discomfort, or loss of routine
  • More common in sensitive or senior dogs
  • Provide a quiet, safe space for rest and recovery
  • Stick to a consistent feeding and walking schedule

Calm praise, soft bedding, and soothing activities like gentle brushing or puzzle toys can help. Avoid scolding clingy behavior—instead, reward calm moments. If anxiety seems severe or affects healing, your vet may suggest calming supplements or behavior advice. Most dogs regain independence as they feel better physically.

Complications in Bilateral FHO Cases

When both hips are operated on, recovery can be more complex. Dogs with bilateral FHO often face slower mobility progress because neither leg has a fully stable joint. In the early weeks, they may struggle with standing, walking, or balancing. This doesn’t mean failure—it just means extra support and time are needed.

  • Delayed weight-bearing on both hind legs
  • Greater risk of falls or muscle atrophy early on
  • May need sling support for longer than single-leg cases
  • Rehab must focus on strength, balance, and coordination

You’ll need to supervise all movement and offer frequent, short rehab sessions. Hydrotherapy can be especially helpful for building muscle without impact. With patience and structured rehab, dogs can still regain good mobility and live comfortably. Work closely with your vet and rehab team to adjust the plan as needed. Progress may be slower, but it’s still possible.

Secondary Strain and Compensatory Injuries

When one leg is healing, other parts of the body often work harder—and that can create new challenges during recovery.

Strain on Opposite Limb or Spine

Dogs often shift weight to the non-operated leg or their front limbs while recovering. This overcompensation can strain joints, muscles, and even the spine. While it helps them stay mobile short-term, it may lead to soreness, stiffness, or joint problems elsewhere if not addressed early.

  • Common in large or overweight dogs with weak core muscles
  • Signs include limping on the “good” leg, back arching, or slower movement
  • May show stiffness after rest or changes in posture
  • Excess pressure on wrists, elbows, and lower back is possible

Balanced rehab exercises like core work, swimming, and even-supported walking reduce the load on overused limbs. Always monitor your dog’s full-body movement—not just the surgical leg. If new limping or fatigue appears, talk to your vet or rehab therapist to adjust the plan and protect the rest of the body.

Arthritis in Adjacent Joints

When your dog’s walking pattern changes after FHO, it can slowly affect other joints. Over time, unnatural movement can cause stress in the knees, lower back, or even front legs, leading to arthritis. This risk increases if your dog stays overweight, skips rehab, or never fully rebuilds muscle.

  • Happens due to long-term uneven weight distribution
  • Most common in hips, knees, and lumbar spine
  • Signs include joint stiffness, difficulty rising, or clicking sounds
  • May appear months or years after surgery

Preventing arthritis starts with strong, balanced rehab and lifelong weight management. Joint supplements like glucosamine and omega‑3s may help protect cartilage. Regular low-impact exercise like walking or swimming also keeps joints mobile.

Even after FHO recovery ends, your vet should reassess joint health during annual checkups. Long-term care keeps your dog comfortable and active well into their senior years.

Factors That Worsen Complication Risks

Some complications can’t be fully avoided—but many are made worse by underlying issues or common mistakes during recovery.

Underlying Health Conditions

Dogs with other health problems may face a slower, more difficult FHO recovery. Obesity, thyroid disease, arthritis, or diabetes can affect healing, increase inflammation, or limit mobility. These issues put more stress on joints and muscles, which increases the risk of complications.

  • Obesity adds strain and delays weight-bearing
  • Arthritis in other joints can limit exercise tolerance
  • Endocrine conditions may slow healing or cause fatigue
  • Diabetes may increase the risk of infection

It’s important to talk to your vet about all existing conditions before surgery. They may adjust the recovery plan, medications, or rehab pace. Weight loss, bloodwork monitoring, and joint supplements may also be added. Managing health issues properly helps reduce risks and supports a safer, smoother recovery after FHO.

Rehab Mistakes and Owner Errors

Even small mistakes during recovery can cause big problems after FHO. Skipping rehab, letting your dog off-leash too soon, or missing medications can lead to pain, injury, or delayed healing. The early weeks are critical for joint protection and muscle rebuilding.

  • Skipping rehab allows stiffness and weakness to develop
  • Off-leash activity risks falls, twisting, or re-injury
  • Missed pain meds may cause discomfort and leg avoidance
  • Overfeeding during crate rest leads to weight gain

Always follow your vet’s instructions closely. Use a calendar or app to track rehab sessions and medication times. Keep your dog confined during rest periods, even if they seem energetic. The more consistent you are with care, the fewer setbacks you’ll face—and the better your dog’s long-term outcome will be.

When to Contact Your Vet Immediately

Knowing when to call your vet can make all the difference during FHO recovery. Some signs should never be ignored, even if they seem small. Acting quickly can prevent a minor issue from becoming a serious complication. Trust your instincts—if something feels off, it’s better to ask.

  • Swelling, redness, or pus at the incision site
  • Foul odor, bleeding, or incision opening
  • Fever, heavy panting, shaking, or loss of appetite
  • Refusal to bear weight after two weeks
  • Sudden limping, crying, or dragging the leg
  • Signs of pain despite medication

Contact your vet right away if you notice any of these symptoms. Don’t wait until your next scheduled visit. Early treatment helps avoid more invasive care later and keeps recovery on track. Your vet is there to support both you and your dog through every stage of healing.

FAQs About FHO Complications in Dogs

Is it normal for my dog to limp weeks after FHO?

Yes, a mild limp is common for several weeks after surgery. It usually improves with rehab and time. If the limp gets worse, doesn’t improve by 8–10 weeks, or is paired with pain or leg avoidance, talk to your vet. Limping without pain is often just part of the adjustment to the new joint.

Can FHO fail or need a second surgery?

Most dogs recover well, but in rare cases, a second surgery may be needed. This can happen if bone remnants cause pain or if infection develops. Your vet may recommend imaging if progress stalls. While not common, surgical revision or extended rehab can improve long-term outcomes in dogs that don’t respond as expected.

What if my dog doesn’t want to use the leg?

Some dogs hesitate to use the leg out of fear, weakness, or past pain. This is called learned non-use. Encourage slow rehab, offer support with a sling, and reward small steps. If your dog refuses completely after 3–4 weeks, ask your vet about pain control, muscle strength, or possible complications affecting movement.

Will my dog always have a shorter leg?

The operated leg may appear slightly shorter after FHO because the femoral head is removed. This is normal and expected. Most dogs adapt well and build enough muscle to compensate. While a minor limp or stride difference may stay, it rarely affects quality of life or daily movement if recovery goes well.

How long until my dog walks normally after FHO?

Most dogs begin walking with some weight on the leg by week 2–3 and show steady improvement by week 6. Full walking comfort may take 8–12 weeks depending on age, weight, and rehab. Minor gait changes may remain, but normal, pain-free movement is the goal and often achievable with good care.

Get a Free Poster

Enhance your workspace with a high-quality radiographs reference poster, designed for veterinary professionals. This free physical poster will be shipped directly to you—just fill out the form to request your copy.

Related posts

Get a Free Poster for Your Clinic

Enhance your workspace with a high-quality radiographs reference poster, designed for veterinary professionals. This free physical poster will be shipped directly to you—just fill out the form to request your copy.

We'd love you to
Join Us!

Enter Your Details Below to Receive Your Information Pack

100% safe & secure. Your details are never shared or sold.

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Taking Great TPLO Radiographs

Click Below to Watch Live Video Demos

We'll send you a Free Wall Poster with all the steps

Now that you are a pro at TPLO rads

Let's take your infection control to the next level

Watch these videos!

Step #1

Getting Ready

Ensuring a clean surgical field starts with proper skin preparation. This video demonstrates the best practices for:

  • Shaving the patient – Achieving a close, even shave while minimizing skin irritation
  • The Dirty Scrub – The initial skin prep step to remove surface debris and reduce bacterial load before the sterile scrub.

Following these techniques helps reduce infection risk and improve surgical outcomes. Watch the video to see how it’s done effectively!

Step #2

Reduce Your Risks

Many surgeons are shocked to find out that their patients are not protected from biofilms and resistant bacteria when they use saline and post-op antibiotics.

That’s Where Simini Comes In.

Why leave these risks and unmanaged?  Just apply Simini Protect Lavage for one minute. Biofilms and resistant bacteria can be removed, and you can reduce two significant sources of infection.

Step #3

Take the Course

Preventing surgical infections is critical for patient safety and successful outcomes. This course covers:

  • Aseptic techniques – Best practices to maintain a sterile field.
  • ​Skin prep & draping – Proper methods to minimize contamination.
  • ​Antibiotic stewardship – When and how to use perioperative antibiotics effectively.

Stay up to date with the latest evidence-based protocols. Click the link to start learning and earn CE credits!

Get Your
Free Poster!

Enter your information below, and we’ll ship it to you at no cost.

Do you want to customize it?

How many would you like?

About you

Shipping information

100% safe & secure. Your details are never shared or sold.

We will work on your request shortly.
Oops! Something went wrong while submitting the form.
What’s your role in animal care?

Tell us who you are so we can guide you to the most relevant information.