Blog
 » 
Femoral Head Ostectomy
 » 
Femoral Head Ostectomy vs. Total Hip Replacement in Dogs

Femoral Head Ostectomy vs. Total Hip Replacement in Dogs

Femoral Head Ostectomy

X min read

Owners

Compare FHO and THR in dogs. Learn the pros, cons, costs, recovery, and which option suits your dog’s size, age, and lifestyle best

By 

Sustainable Vet Group

Updated on

June 26, 2025

.

What’s the Difference Between FHO and THR?

Femoral Head Ostectomy (FHO) and Total Hip Replacement (THR) are two surgeries used to treat severe hip problems in dogs, but they work in very different ways.

FHO involves removing the femoral head, the ball part of the hip joint. After removal, the body forms a fibrous false joint made of soft tissue. This structure cushions the joint and allows pain-free movement, though some function may be reduced.

In contrast, THR replaces both the femoral head and the socket with artificial implants, creating a new, smooth joint surface. This restores full joint structure and offers more natural motion, especially in large or active dogs.

FHO is simpler and less expensive but may not offer the same range of motion. THR gives better joint function but is more complex and costly, requiring careful case selection and recovery.

Which Dogs Are Best Suited for Each Surgery?

Femoral Head Ostectomy (FHO) and Total Hip Replacement (THR) are selected based on a dog’s size, age, and activity level.

FHO is generally better for small to medium-sized dogs, usually under 20–25 kg (45–55 lbs). These dogs often adapt well to the false joint formed after surgery. FHO is also used in cases where cost is a concern or when other health issues make THR too risky.

THR is ideal for larger dogs or highly active breeds, especially those who need full joint function for work, running, or athletic play. It offers more natural movement and strength.

Age is another factor. THR requires skeletal maturity, usually around 10–12 months old, to ensure stable implant placement. FHO can be performed at younger ages in some cases.

Lifestyle also plays a role. FHO suits lower-energy dogs or those with mild muscle loss. THR is better for dogs expected to return to high activity. Your vet will assess your dog’s build, age, and daily function to guide the best surgical choice.

Comparing Surgery Risks and Complexity

FHO and THR differ in complexity and risk, and choosing the right one involves understanding what each surgery requires.

  • FHO is considered a less invasive and technically simpler procedure. It involves removing the femoral head without entering the joint capsule deeply. Complications are rare, and recovery is usually straightforward in smaller dogs.
  • THR, on the other hand, is a more advanced surgery. It requires specialized implants, precise bone cuts, and careful placement of both the socket and ball components. This surgery takes longer, needs a highly trained surgeon, and carries greater risks—especially related to anesthesia, infection, and implant complications.

Despite these risks, THR is often preferred when joint function must be fully restored, such as in large breeds with severe arthritis or dysplasia. FHO may be favored for dogs with medical concerns, budget limits, or when joint damage is not extensive.

Your vet or surgeon will weigh these factors—including recovery potential and long-term goals—before recommending the most suitable approach.

Cost Comparison: FHO vs. THR

The cost of FHO and THR can vary based on your location, the veterinary surgeon’s expertise, and your dog’s specific case.

  • FHO surgery typically costs $1,000 to $2,500. This often includes pre-op bloodwork, surgery, pain meds, and follow-up care.
  • THR is more expensive, ranging from $4,000 to $8,000 per hip, depending on implant type and facility. It also covers X-rays, advanced anesthesia, implant materials, surgical fees, and longer post-op monitoring.

FHO has a lower upfront cost and fewer material needs, making it more accessible for many dog owners. However, THR may offer better long-term function, especially in large or active dogs—possibly reducing future rehab costs or mobility issues.

It’s important to consider both short-term affordability and long-term quality of life. While THR is more expensive, the improved comfort and mobility may justify the higher cost in many cases. Your vet will help break down what's included in the estimate so you can make an informed decision.

Recovery Time and Rehabilitation Needs

Both FHO and THR require careful recovery, but the timelines and expectations differ.

  • FHO recovery is typically shorter. Dogs often begin weight-bearing within a few days to 1 week, and most regain good walking ability by 4–6 weeks. Physical therapy is key to rebuilding strength and balance. Exercises start slowly and progress over 6–12 weeks.
  • THR recovery takes longer and is more structured. Dogs are usually confined to limited movement for 6–8 weeks, with leash walks and controlled rehab. Physical therapy focuses on restoring range of motion, balance, and joint use. Full recovery can take 12–16 weeks or longer.

In both cases, post-op care includes pain control, anti-inflammatory meds, suture removal, and vet follow-ups. Jumping, running, and rough play are restricted during early healing.

THR requires more frequent rechecks to monitor implant placement. FHO patients benefit from consistent at-home exercises and hydrotherapy. While both procedures lead to good outcomes, success depends heavily on owner compliance with rehab and post-op instructions.

Long-Term Outcomes: What to Expect

Both FHO and THR offer good long-term results, but they differ in joint function and comfort over time.

  • FHO creates a fibrous false joint. Dogs typically regain strong mobility and pain relief, though a slight limp or reduced range of motion may persist. Most small to medium-sized dogs do very well, especially with early physical therapy. Muscle tone often returns gradually, though some asymmetry may remain.
  • THR offers the most natural joint function, especially in larger breeds. Dogs usually regain a smooth gait, full leg use, and a higher level of physical activity. Once fully healed, many dogs return to running, swimming, and even agility work with no visible lameness.

Both procedures dramatically improve quality of life for dogs suffering from hip pain. Reported satisfaction is high among owners for both surgeries when post-op care is followed closely.

Overall, THR provides superior function but requires more investment. FHO is a reliable alternative with fewer resources needed—especially for dogs not demanding peak performance.

Potential Complications to Watch For

Each surgery has its own set of possible complications, though most dogs recover well when care is properly managed.

FHO complications may include:

  • Persistent or returning pain
  • Limb shortening causing mild gait changes
  • Weakness or instability in the operated leg
  • Delayed or incomplete muscle regrowth

These are more likely in large dogs or those who skip rehab.

THR complications can be more serious, including:

  • Implant dislocation if the joint isn’t protected during healing
  • Infection, which may require implant removal
  • Loosening or wear of the implant over time
  • Nerve injury during the procedure (rare)

Strict post-op restrictions help avoid most issues. THR requires more frequent checkups to monitor implant stability, especially in active dogs.

In both surgeries, careful follow-up, pain management, and rehab are key to preventing problems. If signs like swelling, limping, or reluctance to use the leg return, prompt veterinary attention is needed.

Making the Right Choice for Your Dog

Choosing between FHO and THR depends on your dog’s size, lifestyle, pain level, and your resources. Here’s a simple way to look at it:

  • FHO is practical for small to medium-sized dogs, dogs with lower activity needs, or owners seeking a more affordable and lower-risk solution. It offers good pain relief and function, especially with early rehab.
  • THR is ideal for larger, active dogs or those needing more complete joint restoration. It provides a smooth, stable joint and excellent mobility but requires more aftercare and cost.

Questions to discuss with your vet:

  • Is my dog a candidate for THR based on size and health?
  • How severe is the hip damage, and can FHO provide enough relief?
  • What post-op care and rehab will be required in each case?
  • Are there any risks based on my dog’s age or condition?

A thoughtful discussion with your veterinary surgeon ensures the best outcome for your dog’s comfort and mobility.

FAQs

Is FHO or THR better for large dogs?

Total Hip Replacement (THR) is generally the better option for large dogs. It restores full joint function, offers better limb alignment, and reduces long-term joint stress. While some large dogs do well with FHO, they may have ongoing weakness or limping due to the false joint. THR provides more stable, pain-free movement and is often recommended when size and activity demands are high.

Can my dog walk normally after FHO?

Yes, many dogs walk normally after Femoral Head Ostectomy (FHO), especially smaller breeds. While some dogs may have a slight limp or reduced range of motion, most regain strong walking ability and are pain-free. With proper rehab, muscle strength improves and compensates for the missing joint, allowing dogs to walk, run, and play comfortably in daily life.

How long does it take to recover from THR?

Recovery from Total Hip Replacement typically takes 12 to 16 weeks. Dogs are kept on restricted activity for the first 6–8 weeks, followed by gradual rehab. Physical therapy, controlled leash walks, and regular vet checks help ensure proper healing. Most dogs return to full activity and comfort by 4 months, though some may need longer based on age or fitness.

Is FHO painful for dogs long-term?

FHO usually provides long-lasting pain relief, especially when performed early and followed by rehab. Some dogs may experience minor discomfort or muscle imbalance long-term, especially large breeds. However, most dogs don’t show signs of pain and adjust well to the false joint. Consistent exercise, healthy weight, and muscle support help maintain comfort over time.

What happens if I can’t afford THR?

If THR is not affordable, FHO is a reliable alternative—especially for small or medium dogs. It’s less expensive and still offers pain relief and good mobility when combined with rehab. In some cases, conservative management (like weight control, joint supplements, and physical therapy) may help delay surgery. Your vet can guide you on the best budget-friendly plan for your dog’s needs.

Can a failed FHO be corrected with THR later?

Yes, Total Hip Replacement can be performed after a failed FHO, though the surgery is more complex. Scar tissue, bone changes, or muscle atrophy from the earlier procedure may affect implant placement. Still, experienced surgeons can often restore function and comfort with THR. If FHO doesn’t relieve pain or causes long-term issues, THR may be a viable second option.

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.