Blog
 » 
Femoral Head Ostectomy
 » 
Long-Term Outcomes of FHO Surgery in Dogs

Long-Term Outcomes of FHO Surgery in Dogs

Femoral Head Ostectomy

X min read

Owners

Explore long-term outcomes of FHO surgery in dogs—recovery timeline, mobility, quality of life, and what to expect post-surgery

By 

Sustainable Vet Group

Updated on

June 25, 2025

.

Does FHO Surgery Improve a Dog’s Long-Term Quality of Life?

  • Pain reduction over time
    Most dogs experience steady pain relief as healing progresses. The removal of the femoral head eliminates bone-on-bone contact, which greatly reduces chronic discomfort.
  • Overall comfort in daily activities
    Dogs typically return to normal or near-normal activity levels after recovery. They walk, run, and play comfortably, especially when rehab exercises are followed properly.
  • Owner satisfaction reports
    Studies show that 83–96% of dog owners report positive long-term outcomes after FHO surgery. This includes restored mobility, better temperament, and improved energy levels.

Over time, dogs regain function in the affected limb and adapt well to the “false joint.” While minor gait changes can remain, they usually don’t affect the dog’s comfort or activity. With proper care, most dogs enjoy a pain-free life and stay active for years after FHO.

How Well Do Dogs Walk After FHO Surgery?

Most dogs walk well after FHO surgery, especially once the healing process is complete.

  • Gait returns to near-normal: Within a few weeks, many dogs start walking and even trotting with minimal signs of discomfort.
  • Mild limps or bunny-hopping may appear: Some dogs develop minor adaptations like a mechanical limp or occasional bunny-hopping, especially during fast movement. These don’t usually affect daily function.
  • Recovery timeline: Most dogs begin bearing weight in 1–2 weeks. Comfortable walking is often seen by 4–6 weeks, with near-full recovery taking 3–6 months.

Smaller breeds often recover faster and with fewer visible changes. For larger dogs, it might take more time and support. Still, pain reduction is quick, and quality of life improves significantly after surgery. Owners often report their dogs appear more active and willing to move shortly after the initial recovery period.

What Physical Changes Might Persist After Surgery?

After FHO, some physical changes can remain long-term, even with good recovery.

  • Muscle atrophy: The thigh and hip muscles may shrink due to pre-surgical limping or disuse. While rehab helps, full muscle mass may not return.
  • Leg shortening: Removing the femoral head can cause the surgical limb to appear slightly shorter. This usually doesn’t affect mobility.
  • Decreased range of motion: Without a true joint, hip flexibility may be reduced. Dogs compensate well, but some stiffness might stay.
  • Weight-bearing ability: While walking may look normal, some dogs shift more weight to the opposite leg when standing still.

These changes are often mild and don’t limit function. Most dogs adapt fully, especially if they’re active and supported with good rehab. Long-term comfort remains excellent despite these small structural differences.

What Kind of Joint Forms After FHO Surgery?

FHO creates a fibrous pseudo-joint in place of the natural hip joint.

Once the femoral head is removed, no bony connection remains between the femur and pelvis. Instead, the body forms a soft tissue capsule filled with fibrous tissue. This tissue cushions the joint, allowing smooth, pain-free movement.

Though not a real joint, the pseudo-joint acts as a shock absorber. It molds to the dog’s motion patterns over time. This adaptability supports walking, running, and even playful activity in most dogs.

The joint’s long-term durability is excellent, especially when weight is controlled and rehab is consistent. While large dogs might show slight instability or reduced motion, the fibrous joint holds up well in the long run.

What Factors Affect Long-Term Outcomes?

Several things impact how well a dog recovers after FHO:

  • Dog’s size and body weight: Smaller dogs tend to recover better. Larger breeds may need longer rehab and may show more noticeable gait changes.
  • Chronic vs acute hip issues: Dogs with long-standing arthritis or hip dysplasia may have more muscle loss before surgery, affecting results. Dogs with recent trauma often do better.
  • Surgical alternatives: In some cases, especially in large or active dogs, total hip replacement (THR) may offer smoother motion and a more natural gait. Still, FHO remains a great option when cost or health limitations rule out THR.

In general, FHO provides excellent comfort and good function in most dogs. The key is matching the procedure to the dog’s size, health, and activity level.

Role of Rehab in Long-Term Success

Rehabilitation is one of the most important parts of FHO recovery.

  • Start early: Light rehab usually begins within a few days post-surgery to maintain joint motion and avoid muscle loss.
  • Hydrotherapy is very effective: Water-based exercises help build strength without stressing the joint.
  • Rehab duration varies: Some dogs may need a few weeks, while older or larger dogs benefit from longer therapy plans.

Exercises like leash walks, sit-to-stand drills, and gentle hill work can be added as healing progresses. Rehab not only improves muscle strength but also teaches the dog to use the leg properly again. Follow-ups with your vet or a certified canine rehab specialist ensure the exercises are working. A strong rehab plan often makes the difference between average and excellent outcomes.

Final Thoughts: Is FHO a Reliable Long-Term Option?

FHO is a reliable and proven surgery, especially for:

  • Small to medium-sized dogs
  • Dogs with hip injuries, fractures, or chronic joint pain
  • Cases where cost or health limits more advanced surgery like THR

While some changes in gait or muscle tone may remain, dogs usually regain full function. Most live pain-free, active lives with no ongoing medication or surgery needed. Larger dogs can still do well with FHO, but their success depends heavily on proper rehab and weight control.

Your vet will help determine if FHO is right for your dog. When combined with thoughtful aftercare and consistent support, it offers lasting relief and good quality of life for years to come.

FAQs

Can dogs live a normal life after FHO surgery?

Yes, most dogs live a very normal and active life after FHO surgery. Once healed, they can walk, run, and play comfortably. Some dogs may have a slight limp or reduced range of motion, but these issues rarely affect their quality of life. With good rehab and proper care, long-term pain relief and function are excellent, especially in small to medium-sized dogs.

How long does it take for a dog to fully recover from FHO?

Full recovery typically takes 3 to 6 months. Most dogs begin bearing weight within 1 to 2 weeks and walk comfortably by 4 to 6 weeks. Rehab speeds up the healing process and helps rebuild lost muscle. Even after reaching full function, some dogs may continue to improve in strength and coordination over time with continued activity and exercise.

Will my dog limp permanently after FHO?

Some dogs may have a mild limp that shows up when they’re tired or moving quickly, but it’s usually not permanent or painful. In many cases, the limp fades over time with rehab and strengthening. Even if a minor limp remains, most dogs don’t show signs of discomfort and can live a very active, happy life.

Is FHO surgery effective in large breeds long-term?

FHO can work in large dogs, but results vary more than in smaller breeds. Success depends on factors like body weight, muscle condition, and rehab effort. Large dogs may retain a noticeable gait change or reduced strength, but many still do well. For very active or working dogs, total hip replacement may offer better function in the long term.

What is a false joint, and does it last?

A false joint, or pseudo-joint, is a fibrous capsule that forms after the femoral head is removed. It’s not made of bone or cartilage but allows smooth, cushioned movement. This structure holds up well over time and provides lasting pain relief. While it doesn’t restore full range of motion, it typically allows good mobility for life.

Does physiotherapy really make a difference long-term?

Yes, physiotherapy has a major impact on long-term success. It helps restore muscle strength, improve joint motion, and teach your dog to use the leg properly again. Dogs who receive structured rehab often recover faster and show better function long-term. Skipping rehab can lead to stiffness, weakness, and less complete recovery.

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.