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When Is FHO Surgery Recommended for Dogs?

When Is FHO Surgery Recommended for Dogs?

Femoral Head Ostectomy

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Discover when Femoral Head Ostectomy (FHO) surgery is recommended for dogs, including common conditions and signs needing surgical care

By 

Sustainable Vet Group

Updated on

June 9, 2025

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Understanding FHO Surgery

Femoral Head Ostectomy (FHO) is a surgical procedure where the head and neck of the thigh bone (femur) are removed. This surgery is done to relieve severe pain caused by hip problems like arthritis, fractures, or hip dysplasia.

FHO helps dogs by eliminating the painful bone-on-bone contact inside the hip joint. After surgery, the body forms a “false joint” made of fibrous tissue, which cushions the area and allows more comfortable movement. Although it’s not a normal joint, this new structure reduces pain and improves mobility.

This surgery is often recommended when other treatments like medication or physical therapy have not worked. It allows dogs to regain the use of their leg and live with less discomfort. FHO can be especially helpful for dogs with severe hip damage or those who cannot have more complex surgeries like total hip replacement.

How Veterinarians Diagnose the Need for FHO Surgery

Veterinarians use a combination of physical exams and diagnostic imaging to determine if Femoral Head Ostectomy (FHO) surgery is needed for your dog.

  • Physical exam: The vet will assess your dog’s hip joint by checking for pain, swelling, decreased range of motion, and signs of lameness or instability. They will observe how your dog walks and moves to identify discomfort or limited mobility.
  • Diagnostic imaging: X-rays are essential to see the condition of the hip joint, including bone damage, arthritis, fractures, or deformities. These images help confirm the diagnosis and guide treatment decisions.
  • Signs and symptoms: Dogs showing severe hip pain, persistent limping, difficulty standing or walking, and poor response to medication or physical therapy are often evaluated for surgery.
  • Additional tests: In some cases, advanced imaging like CT or MRI may be used for detailed views of the joint structures.

After evaluating these findings along with your dog’s age, size, and overall health, the vet decides if FHO surgery is the best option to relieve pain and improve mobility. Early diagnosis helps plan effective treatment and improve outcomes.

Medical Conditions That Indicate FHO Surgery

Femoral Head Ostectomy (FHO) surgery is often recommended for dogs suffering from specific medical conditions that cause severe hip pain and joint damage.

  • Hip dysplasia and severe arthritis: Hip dysplasia is a genetic condition where the hip joint forms abnormally, leading to arthritis and chronic pain. When arthritis becomes severe, FHO can relieve pain by removing the damaged femoral head.
  • Traumatic hip injuries: Fractures or dislocations of the femoral head or neck caused by accidents or trauma may require FHO if the bones cannot be repaired. This surgery helps restore comfort and function.
  • Legg-Calve-Perthes disease: This condition causes the femoral head to deteriorate (necrosis) due to poor blood supply. FHO removes the damaged bone to eliminate pain and improve mobility.
  • Degenerative joint disease in older dogs: Age-related joint wear and tear can cause chronic hip pain. When other treatments fail, FHO can improve quality of life by reducing discomfort and increasing mobility.

Your vet will assess these conditions through exams and imaging to determine if FHO is the best surgical option for your dog’s specific needs.

When Conservative Treatments Are Not Enough

Conservative treatments like medication, rest, and physical therapy are often the first steps in managing hip problems in dogs. However, these approaches may not always provide enough relief.

  • Medication failure: Pain relievers and anti-inflammatory drugs can reduce discomfort temporarily, but if your dog continues to show pain or limping, medication alone may not be sufficient.
  • Rest and activity modification: Limiting activity can help reduce stress on the hip joint, but persistent discomfort despite rest indicates the need for further intervention.
  • Physical therapy limitations: While rehab exercises strengthen muscles and improve joint function, some dogs do not respond well enough to prevent ongoing pain or mobility issues.

When pain and limited mobility continue despite these treatments, it suggests the hip joint damage is severe. At this stage, Femoral Head Ostectomy (FHO) surgery may be recommended to relieve pain and improve quality of life.

Your vet will carefully evaluate your dog’s response to conservative care before suggesting surgery, ensuring that FHO is the best option for lasting relief and better mobility. Early surgical intervention can prevent further decline and discomfort.

Ideal Candidates for FHO Surgery

Femoral Head Ostectomy (FHO) surgery is best suited for certain groups of dogs based on their size, health, and response to other treatments.

  • Small to medium-sized dogs: FHO works especially well for dogs under 50 pounds. Their lighter weight allows the “false joint” formed after surgery to support movement effectively, leading to better recovery and mobility.
  • Dogs with poor response to previous treatments: If your dog has had medication, physical therapy, or other hip surgeries without sufficient pain relief or improvement, FHO may be the next best step to address ongoing discomfort.
  • Dogs with significant reduction in quality of life: When hip pain severely limits your dog’s ability to walk, run, play, or enjoy daily activities, surgery can greatly improve comfort and function.

Vets consider factors like your dog’s age, overall health, activity level, and severity of joint damage when recommending FHO. While FHO may not be suitable for every dog, it offers excellent pain relief and improved mobility for many. Discussing your dog’s specific situation with your vet helps ensure the best treatment choice.

FHO Surgery as an Alternative to Total Hip Replacement

Total hip replacement (THR) is a highly effective surgery that replaces the entire hip joint with an artificial implant. However, THR may not always be feasible or affordable for every dog and owner.

  • When THR is not feasible: Some dogs, especially smaller breeds or those with certain health issues, may not be good candidates for THR due to surgical complexity or recovery demands.
  • Cost considerations: THR is usually more expensive than Femoral Head Ostectomy (FHO), making FHO a practical option for many owners seeking pain relief for their dogs.

FHO is a less invasive salvage procedure that removes only the damaged femoral head and neck, reducing pain and improving mobility without the need for artificial implants.

  • Benefits of FHO: It generally has a shorter surgery time, fewer risks, and a good success rate, especially in smaller dogs. The formation of a “false joint” allows dogs to regain comfortable movement.

While THR can provide better long-term joint function for some, FHO remains a valuable, effective alternative for dogs needing pain relief with fewer surgical demands.

Expected Outcomes and Quality of Life Improvements

Femoral Head Ostectomy (FHO) surgery significantly improves pain and mobility in dogs suffering from severe hip problems. By removing the damaged femoral head and neck, FHO eliminates painful bone-on-bone contact, allowing dogs to move more comfortably.

  • Pain relief: Most dogs experience a noticeable reduction in hip pain soon after surgery, which helps them regain willingness to walk, run, and play.
  • Improved mobility: As muscles strengthen and the “false joint” forms, dogs regain better use of their leg, leading to a more active and happier life.
  • Adaptation: Dogs naturally adjust to the new joint structure, often returning to normal activities with minimal discomfort.

Post-surgery rehabilitation plays a crucial role in maximizing these benefits. Physical therapy helps rebuild muscle strength, improve flexibility, and support joint stability. Controlled exercise and guided rehab reduce stiffness and prevent muscle loss, speeding recovery.

With proper care and rehab, most dogs enjoy a significant improvement in quality of life after FHO surgery, living comfortably and actively without the pain caused by their damaged hip joint.

Conclusion

Femoral Head Ostectomy (FHO) is a valuable surgical option for dogs suffering from severe hip pain caused by conditions like arthritis, fractures, or hip dysplasia. It relieves pain by removing the damaged femoral head, stopping painful bone-on-bone contact. This surgery improves mobility and helps dogs regain comfort, especially when conservative treatments have failed.

FHO is often recommended for small to medium-sized dogs or those that cannot undergo more complex surgeries like total hip replacement. The formation of a “false joint” allows dogs to move with less pain and better function.

Recovery and rehabilitation are important for the best results. If your dog shows signs of hip pain or difficulty moving, consulting your vet early is key. Personalized advice ensures the right treatment plan for your dog’s specific needs, helping them live a happier, more comfortable life.

FAQs

What dogs are the best candidates for FHO surgery?

Small to medium-sized dogs are the best candidates for FHO surgery because their lighter weight allows easier adaptation to the “false joint.” Dogs that have severe hip pain from arthritis, fractures, or hip dysplasia, and those who do not respond to conservative treatments, are also good candidates.

How long does recovery take after FHO surgery?

Recovery after FHO surgery usually takes 6 to 12 weeks. During this time, dogs need restricted activity and physical therapy to rebuild muscle strength and improve joint mobility. Full recovery can take several months depending on the dog’s size and health.

Can large dogs benefit from FHO surgery?

Large dogs can have FHO surgery, but recovery is often more challenging due to their weight. The “false joint” must support more load, which may affect mobility. Alternative treatments or total hip replacement may be better for larger dogs with severe hip issues.

Is FHO surgery painful for dogs?

FHO surgery is performed under general anesthesia, so dogs don’t feel pain during the operation. Post-surgery, pain is managed with medications prescribed by the vet to keep your dog comfortable during healing.

What are the risks of not treating severe hip problems?

Untreated severe hip problems can lead to chronic pain, arthritis, decreased mobility, muscle loss, and a poor quality of life. Over time, the condition worsens, causing more discomfort and difficulty with normal activities.

How does FHO compare to total hip replacement?

FHO removes the femoral head to stop pain, forming a “false joint,” while total hip replacement replaces the entire hip joint with an artificial implant. THR may offer better long-term function but is more complex and costly. FHO is less invasive and often preferred for smaller dogs or when THR isn’t feasible.

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