What Is Femoral Head Ostectomy in Dogs?
Learn about femoral head ostectomy (FHO) surgery in dogs, its purpose to relieve hip pain, and how it helps improve mobility and quality of life

What Is Femoral Head Ostectomy (FHO)?
Femoral Head Ostectomy (FHO) is a surgical procedure for dogs where the head of the thigh bone (femur) is removed. This surgery is done to relieve severe pain caused by hip problems. Without the femoral head, the painful bone-on-bone contact in the hip joint stops, which reduces discomfort.
FHO is usually performed when other treatments, like medication or therapy, have not helped. Common reasons for FHO include hip dysplasia, severe arthritis, fractures, or injury that damage the hip joint. The main goal of the surgery is to improve your dog’s comfort and quality of life by stopping the pain from a damaged hip.
After surgery, the body forms a “false joint” where the femoral head was removed. This new joint allows your dog to move more comfortably without the usual pain caused by the damaged bone. FHO can be very effective in helping dogs regain mobility.
Why Do Dogs Need FHO Surgery?
Femoral Head Ostectomy (FHO) surgery is recommended when dogs have severe hip problems that cause pain and limit movement. It is often chosen when other treatments like medication or physical therapy do not provide enough relief.
Common causes that lead to FHO surgery include:
- Hip dysplasia: A genetic condition where the hip joint develops abnormally, causing pain and arthritis.
- Severe arthritis: Wear and tear in the hip joint that causes inflammation, stiffness, and chronic pain.
- Trauma or injury: Damage from accidents, such as fractures or dislocations, that severely affect the hip joint.
- Fractures: Broken bones in the femoral head or neck that cannot be repaired easily.
FHO is usually recommended when these conditions cause persistent pain and reduce your dog’s quality of life. It is often chosen over hip replacement surgery for smaller dogs, or when the cost or complexity of other surgeries is not suitable.
The surgery helps relieve pain by removing the damaged bone, allowing your dog to regain mobility and live more comfortably. Your vet will decide if FHO is the best option based on your dog’s age, size, and condition severity.
How Does FHO Surgery Work?
Femoral Head Ostectomy (FHO) surgery involves removing the femoral head and neck—the round top part of the thigh bone that fits into the hip socket. By removing these damaged bone parts, the surgery eliminates painful bone-on-bone contact in the hip joint.
After surgery, the body naturally forms a “false joint” made of fibrous tissue and muscle in place of the removed bone. This false joint acts like a cushion, allowing the leg to move smoothly without bone grinding or pain. Although it’s not a normal joint, this fibrous tissue provides enough support for comfortable movement.
Inside the body, muscles and connective tissue around the hip adapt to stabilize the new joint area. Over weeks to months, scar tissue strengthens and improves flexibility, helping your dog regain use of the leg.
Because the bone is removed, the hip joint no longer causes pain from arthritis, fractures, or injury. The false joint helps your dog move more freely and reduces discomfort, improving quality of life. Proper post-surgery rehab is essential to build muscle and support this new joint.
Who Is a Good Candidate for FHO?
Femoral Head Ostectomy (FHO) is a good option for many dogs, especially those who suffer from severe hip pain that limits their mobility. Typically, smaller dogs weighing less than 50 pounds are ideal candidates because their lighter weight makes it easier for the false joint to support movement. However, dogs of any size or age may benefit from FHO depending on their condition.
Good candidates usually include dogs with:
- Severe hip arthritis causing chronic pain
- Hip dysplasia with joint damage
- Fractures or trauma to the femoral head or neck that cannot be repaired
- Poor response to medication or conservative treatments
FHO is often preferred over more complex surgeries like total hip replacement for younger dogs, smaller breeds, or when cost or health concerns make other options less suitable.
Your vet will evaluate your dog’s age, weight, activity level, and overall health to determine if FHO is the best solution. The goal is to relieve pain and improve mobility, giving your dog a better quality of life.
What to Expect During the Surgery
Femoral Head Ostectomy (FHO) surgery is performed under general anesthesia to ensure your dog is completely unconscious and pain-free. Before the procedure, your vet will conduct a full health check and blood tests to make sure your dog is fit for anesthesia.
During surgery, the vet makes an incision near the hip to access the joint. The femoral head and neck—the top part of the thigh bone—are carefully removed. The area is cleaned, and the muscles and tissues around the hip are sutured to help form the “false joint.” The skin is then closed with stitches or staples.
The surgery usually takes about one to two hours, depending on the dog’s size and condition. After surgery, your dog will be monitored closely as they wake up from anesthesia.
Immediate post-surgery care includes pain management, preventing infection, and limiting movement to protect the surgical site. Your vet will provide detailed instructions on medications and activity restrictions to help your dog heal safely and comfortably.
Recovery and Rehabilitation After FHO
Recovery after Femoral Head Ostectomy (FHO) requires patience and careful management. Physical therapy and gradual weight-bearing are key to helping your dog regain strength and mobility.
- Physical therapy: Helps rebuild muscles around the hip and improve joint movement. Without it, muscle loss and stiffness can slow recovery.
- Gradual weight-bearing: Start with short, gentle walks as your dog feels comfortable. Slowly increase activity following your vet’s guidance.
- Recovery timeline: Most dogs heal significantly within 6 to 12 weeks, but full improvement may take several months. Regular vet visits track progress.
- Owner’s role: Follow all activity restrictions and medication schedules. Assist with home exercises and provide a safe, calm environment.
Your care and attention during recovery greatly influence the outcome. By supporting your dog with controlled activity and rehab, you help ensure a smoother, faster recovery and improve their long-term quality of life.
Expected Outcomes and Benefits
Femoral Head Ostectomy (FHO) surgery offers significant benefits for dogs suffering from severe hip pain. The primary outcome is pain relief by removing the damaged femoral head, which stops the painful bone-on-bone contact in the hip joint.
- Pain relief: Most dogs experience a noticeable reduction in pain soon after surgery, allowing them to move more comfortably.
- Improved mobility: As the false joint forms and muscles strengthen, dogs regain better use of the leg, improving walking, running, and daily activities.
- Adaptation: Dogs naturally adjust to the new joint structure, often returning to an active and happy lifestyle.
The long-term prognosis for most dogs after FHO is excellent, especially when combined with proper rehabilitation and care. While the false joint is not a true hip replacement, it provides enough support for normal movement without pain. Small to medium-sized dogs usually recover faster and have better outcomes, but dogs of all sizes can benefit.
Overall, FHO improves quality of life by eliminating chronic pain and increasing mobility, allowing dogs to enjoy their favorite activities again.
Potential Risks and Complications
While Femoral Head Ostectomy (FHO) surgery is generally successful, there are potential risks and complications to be aware of during recovery.
- Muscle atrophy: Reduced use of the leg after surgery can lead to muscle loss around the hip. Without proper physical therapy, this can slow recovery and reduce strength.
- Reduced range of motion: Scar tissue and stiffness may limit how much your dog can move the leg if rehab is insufficient.
- Infection: Like any surgery, there is a risk of infection at the surgical site, which requires prompt veterinary treatment.
- Lameness or limping: Some dogs may continue to limp or show uneven weight-bearing after surgery, especially if healing is slow or if complications occur.
- Nerve or blood vessel injury: Though rare, surgery may affect nearby nerves or vessels, causing additional issues.
Follow-up care is essential to minimize these risks. Regular veterinary visits allow early detection and management of problems. Strict adherence to activity restrictions, medication schedules, and rehabilitation exercises supports healing and reduces complications. With careful monitoring and care, most dogs recover well and regain comfortable mobility.
Alternatives to FHO Surgery
Femoral Head Ostectomy (FHO) is one option for treating severe hip problems, but there are alternatives depending on your dog’s condition and needs.
- Conservative treatments: These include pain medications, anti-inflammatory drugs, physical therapy, weight management, and joint supplements. Conservative care is often tried first for mild to moderate cases or when surgery isn’t an option due to age or health. While it may help reduce pain, it usually does not fix severe joint damage.
- Total hip replacement (THR): This surgery replaces the entire hip joint with an artificial implant. THR is more complex and expensive but can provide better long-term function and mobility, especially for larger or active dogs. It is often preferred when joint damage is severe but the dog is healthy enough for major surgery.
Choosing between FHO and alternatives depends on factors like your dog’s size, age, activity level, and overall health. FHO may be better for smaller dogs or those who cannot undergo extensive surgery. THR can offer improved outcomes for some dogs but requires a longer recovery. Your vet will help determine the best option based on your dog’s specific situation.
How Veterinarians Diagnose the Need for FHO
Veterinarians use a combination of physical exams and diagnostic tools to determine if Femoral Head Ostectomy (FHO) surgery is necessary for your dog.
- Physical examination: The vet assesses your dog’s hip joint by checking for pain, swelling, range of motion, and signs of instability or lameness. They observe how your dog walks and moves to identify discomfort or limited mobility.
- X-rays: Radiographs help vets see the condition of the hip joint, including bone damage, arthritis, fractures, or deformities. X-rays are essential for confirming the diagnosis and planning treatment.
- Additional tests: In some cases, vets may use advanced imaging like CT scans or MRI to get a detailed view of the joint structures.
After evaluating the exam results and imaging, the vet considers your dog’s age, size, overall health, and lifestyle. They weigh the benefits and risks of surgery versus other treatments.
If pain and joint damage are severe, and conservative treatments haven’t helped, the vet may recommend FHO as the best option to relieve pain and improve mobility. Clear communication with your vet helps ensure the right decision for your dog’s care.
Conclusion
Femoral Head Ostectomy (FHO) is a valuable surgery that helps dogs suffering from severe hip pain caused by conditions like arthritis, fractures, or hip dysplasia. By removing the damaged femoral head, FHO stops painful bone-on-bone contact and allows the formation of a new “false joint.” This procedure significantly reduces pain and improves mobility, helping dogs regain comfort and quality of life.
Recovery requires patience, physical therapy, and owner support, but most dogs adapt well and return to active lives. FHO is often recommended for smaller dogs or when other treatments fail. If your dog shows signs of hip pain or mobility issues, consult your vet early. Understanding FHO can help you make informed decisions to give your dog the best care and a happier, pain-free future.
FAQs About Femoral Head Ostectomy (FHO) in Dogs
What is Femoral Head Ostectomy (FHO) surgery?
FHO is a procedure where the top part of the thigh bone (femoral head) is removed to relieve pain caused by hip joint damage. It stops bone-on-bone contact and helps dogs move more comfortably by forming a “false joint” made of fibrous tissue.
When is FHO surgery recommended for dogs?
FHO is usually recommended for dogs with severe hip pain from arthritis, fractures, hip dysplasia, or trauma, especially when conservative treatments don’t help. It’s often preferred for smaller dogs or when total hip replacement is not suitable.
How long does it take for a dog to recover from FHO?
Recovery typically takes 6 to 12 weeks. During this time, physical therapy and gradual weight-bearing help rebuild muscle and improve mobility. Full recovery may take several months, depending on the dog’s size and health.
What are the risks of FHO surgery?
Possible risks include muscle loss, reduced joint motion, infection, and continued limping. Following post-surgery care and rehabilitation instructions closely helps minimize these risks and improves outcomes.
Can large dogs have FHO surgery?
Yes, large dogs can have FHO, but recovery may be more challenging because of their weight. Vets may recommend alternative treatments or total hip replacement for better long-term results in bigger dogs.
How does the “false joint” work after FHO?
After surgery, fibrous tissue forms where the femoral head was removed, creating a “false joint.” This tissue cushions the hip, allowing pain-free movement even without a true ball-and-socket joint, helping dogs regain function.
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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.
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