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FHO Surgery Success Rate in Dogs

FHO Surgery Success Rate in Dogs

Femoral Head Ostectomy

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Owners

Learn how successful FHO surgery is for dogs, with real stats, recovery timelines, and key factors that affect long-term outcomes

By 

Sustainable Vet Group

Updated on

June 21, 2025

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What Is FHO Surgery and Why It's Done

Femoral Head Ostectomy (FHO) is a surgical procedure where the femoral head and neck are removed to relieve hip joint pain. It’s often used in small to medium-sized dogs when the hip joint is damaged by trauma, arthritis, or diseases like Legg-Calvé-Perthes.

  • Why vets recommend FHO: It’s less invasive and more affordable than total hip replacement.
  • Best for dogs under 50 lbs: These dogs form a functional “false joint” from scar tissue more easily.
  • When it’s preferred: In cases where bone quality is poor, cost is a concern, or total hip replacement isn’t feasible.

After surgery, a fibrous tissue capsule forms in place of the removed joint. This “false joint” lets dogs walk without bone-on-bone contact. The success of FHO depends heavily on post-surgical care, including early movement, physical therapy, and weight management. When done in the right patient, this procedure helps restore pain-free movement and a good quality of life.

How Successful Is FHO Surgery in Dogs?

FHO surgery has a high success rate, especially in smaller dogs. Studies and owner feedback show strong outcomes.

  • Owner satisfaction: Around 93–96% of pet owners report improved quality of life.
  • Clinical outcomes: Most dogs regain near-normal mobility with minimal pain.
  • Short-term recovery: Dogs may limp or have muscle loss early on but show clear improvement by 4–6 weeks.
  • Long-term results: With rehab, most dogs can run, jump, and even hike.

Dogs who receive proper rehab therapy and have good muscle condition before surgery tend to do better. Vets see fewer complications and faster recovery in these dogs. The most important factor? Post-op care at home. With cage rest early on, followed by active physical therapy, most dogs regain strength and mobility. Even dogs with prior pain and stiffness often return to playful, active lives after full recovery.

Factors That Influence Success Rate

FHO outcomes depend on several key factors that dog owners and vets must consider.

  • Dog’s size and weight: Small to medium dogs (<50 lbs) do best.
  • Muscle strength: Pre-surgery conditioning helps with post-op recovery.
  • Weight management: Obese dogs may recover slower and with more complications.
  • Timely surgery: Delayed treatment can lead to more muscle loss.

Surgical skill and proper technique matter, too. But even with excellent surgery, poor aftercare can affect healing. That’s why owners must follow rehab plans closely. Dogs kept active before surgery tend to form stronger “false joints” and recover faster. Dogs with severe muscle wasting or untreated hip pain for long periods may struggle more with post-op mobility.

FHO is not a magic fix—it’s a team effort between vet and owner. With proper planning and care, though, the success rate is high, and the benefits are long-lasting.

Recovery Timeline and What to Expect

The healing process happens in stages and varies by dog, but most follow a general timeline.

  • Day 1–3: Crate rest, pain meds, and short leash potty breaks only.
  • Week 1–2: Passive range-of-motion exercises and short walks begin.
  • Week 3–6: Walking improves; light exercises increase gradually.
  • Week 6–12: Full muscle recovery and normal activity returns.

Dogs usually start weight-bearing within a week, though limping is common. Rehab exercises help rebuild muscle strength. Hydrotherapy, leash walking on inclines, and sit-to-stand drills are often used.

It’s important to monitor your dog’s pain levels and mobility each week. Swelling or lameness that worsens should be reported to your vet. By 3 months, many dogs resume near-normal movement, though some may retain a slight limp. Don’t rush the process. A slow, steady recovery gives the best long-term results.

Possible Long-Term Complications

While FHO is generally successful, there can be long-term issues in some dogs.

  • Limb shortening: A minor leg length difference is common but usually not limiting.
  • Gait changes: Some dogs have a permanent limp or altered stride.
  • Reduced hip motion: Range of motion may not fully return in all cases.
  • Muscle atrophy: Can occur if physical therapy is skipped or limited.

Most of these issues don’t impact quality of life significantly, but they can affect athletic performance in working or very active dogs. These risks are lower in smaller dogs and those who stick to rehab programs. Owners should stay in touch with their vet and schedule check-ups during the recovery period to detect any concerns early.

Bilateral FHO: What If Both Hips Are Affected?

Dogs with problems in both hips can still benefit from FHO—sometimes on both sides.

  • One side at a time: Vets usually recommend staging surgeries.
  • Quality of life: Most dogs return to normal walking after both hips heal.
  • Research support: Studies show high success in bilateral cases.

Rehab is even more critical when both hips are involved. Dogs need help with balance and coordination during recovery. Use of slings or harnesses indoors and careful progress with leash walking helps prevent injury or overuse. With time and support, many dogs with bilateral FHO can run, play, and live happily pain-free.

When Is FHO the Best Option?

FHO is often chosen when other treatments aren’t suitable or accessible.

  • Compared to total hip replacement: FHO is more affordable and less invasive.
  • Best choice for: Smaller dogs, those with poor bone health, or those not suited for implants.
  • When owners can’t afford implants: FHO is a reliable “salvage” procedure.

It’s not ideal for large-breed dogs or those needing high-performance mobility, like working dogs. However, for family pets with chronic hip pain and limited function, FHO can restore comfort and ease of movement. It’s especially helpful for younger dogs with trauma and seniors who can’t tolerate complex surgeries.

FAQs

Is FHO surgery painful for dogs?

Yes, like any surgery, FHO can cause pain at first. However, your vet will prescribe pain medications to manage it during the early days. Most dogs show reduced discomfort within a few days. As healing progresses, pain decreases, and the dog often becomes more active. The long-term goal is to eliminate chronic hip pain caused by the original condition.

Can large breed dogs have a successful FHO?

Large dogs can have successful outcomes, but results are less predictable than in smaller dogs. They may retain a limp or limited range of motion. With strong muscles and proper rehab, some large dogs still regain good function. In general, total hip replacement is often preferred for larger breeds if it's financially and medically possible.

How long before my dog can walk after FHO?

Most dogs begin to bear weight within 3–7 days after surgery. At first, the walk may be wobbly or limping. With gentle rehab, walking improves each week. By 4–6 weeks, dogs typically walk more normally. Full recovery, including muscle rebuilding and pain relief, usually takes about 8–12 weeks.

What are signs the surgery didn’t work well?

Signs of poor recovery include persistent lameness, unwillingness to walk, pain when touching the hip, or muscle wasting over time. These may suggest complications like scar tissue problems or inadequate rehab. If you notice these, consult your vet immediately for re-evaluation and possible therapy adjustments.

Does FHO affect lifespan or activity levels?

FHO does not shorten your dog’s lifespan. With proper care, most dogs return to normal or near-normal activity levels. They can run, play, and live comfortably. Some may have a mild limp, but this usually doesn’t affect their happiness or quality of life. Long walks and active play are still possible after recovery.

Is physical therapy necessary after FHO?

Yes, physical therapy is very important for success. It helps rebuild muscle strength, improves range of motion, and speeds up recovery. Rehab exercises like leash walks, sit-to-stand drills, or hydrotherapy make a big difference. Without it, your dog may limp longer or never fully regain function. Always follow your vet’s rehab plan.

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