Femoral Head Ostectomy (FHO)

What is a FHO?

Femoral head ostectomy (sometimes referred to as a femoral head and neck excision or FHNE) is a surgical procedure that involves the removal of the head and neck of the femur and formation of a “false” soft tissue joint in the hip.  It is considered a salvage procedure and is performed when other surgical procedures are not an option.

When is a FHO indicated?

FHO is indicated in dogs or cats who have suffered:

·         Failed repair of a traumatic luxation (dislocation) of the hip

·         Non-traumatic  luxation  of the hip (severe hip dysplasia)

·         Severe osteoarthritis of the hip

·         Non-repairable fracture of the pelvis or of the head and neck of the femur

·         In cases where financial limitations prevent more aggressive surgical repair such as total hip replacement or fracture repair.

Is my pet a good candidate for FHO?

Ideally, FHO is  performed in dogs weighing less than 50 pounds as long as the opposite limb has normal function. In some cases, when dogs are greater than 50lb and more aggressive surgical repair such as total hip replacement is not an option, FHO can be successful.  Your veterinarian can help you make the best decision for you and for your dog or may refer you to a Board Certified Surgeon.

How long will it take my pet to regain “normal” function?

Because the real joint space is replaced with an artificial soft tissue joint, your dog’s leg will lose a small amount of length and some range of motion. These biomechanical changes automatically preclude your dog from having “normal” gait but with aggressive rehabilitation many gait abnormalities will be noticed only by those with a trained eye. Because the new joint relies on formation of scar tissue and fibrosis most dogs do not reach a maximum plateau of recovery until 6 months post operatively or longer if significant muscle atrophy was present before surgery.

Rehabilitation for dogs with a FHO

The primary goal of rehabilitation for dogs that have had a FHO is to reduce pain, regain range of motion and encourage weight bearing.  Aggressive, regimented physical rehabilitation typically begins as soon as the incision is fully healed.

Recommended modalities for rehabilitation of a FHO include:

• Hydrotherapy to encourage early weight bearing and strengthening
• Low Level Laser Therapy to speed healing and decrease pain
• E-Stim to strengthen atrophied muscles
• TENS to decrease pain
• Home Exercise Plan to promote disciplined and purposeful return to activity