The femoral head ostectomy, or FHO, is a surgical procedure that removes the head and neck of the femur – the “ball” part of the ball-and-socket hip joint. Once the head of the femur is removed, the body will create a “false joint.”
The goal of this surgery is to eliminate pain and improve the pet’s range of motion when the hip joint is damaged or diseased. A femoral head ostectomy is generally considered a salvage procedure, and it’s frequently performed in dogs and cats with hip problems.
Understanding FHO: How it Works and Why It’s Performed
A femoral head ostectomy (FHO) involves removing the head and neck of the femur bone. But what happens then? Let’s take a closer look.
Creating a False Joint
After the surgeon removes the head of the femur, the body creates what’s called a “false joint.” This is essentially a pad of fibrous scar tissue that forms in the space where the femoral head used to be. This false joint prevents bone-on-bone contact, reducing pain.
The muscles around the hip are key to supporting and stabilizing the limb after the surgery. These muscles take over some of the functions of the original hip joint.
Reasons for Performing FHO
FHO is often recommended when other treatments aren’t effective or aren’t an option. Common reasons for performing FHO in dogs and cats include:
- Hip dysplasia
- Hip luxation (dislocation)
- Severe arthritis
- Fractures of the femoral head or neck
- Legg-Calve-Perthes Disease
- Slipped capital femoral epiphysis
Is your pet a good candidate for FHO?
FHO surgery can be a good option for many animals, but it’s not right for every pet. Here are some things to consider.
Ideal candidates
FHO is often recommended for smaller dogs, generally those weighing less than 50 pounds. That’s not a hard-and-fast rule, though, and exceptions can be made based on the animal’s individual circumstances.
FHO is frequently performed on cats, no matter their size.
Activity level and muscle mass
Active animals tend to bounce back more quickly after surgery and have better overall outcomes than less active animals. If your pet has good existing muscle mass, this will also help speed recovery after the FHO procedure.
What to Expect During FHO Surgery
Before surgery, your vet will probably ask you to withhold food from your pet that morning.
The FHO surgery itself is performed under general anesthesia. Your vet will surgically detach and remove the head and neck of the femur.
After the surgery, the veterinary staff will monitor your pet for several hours, or potentially days, to ensure that they are recovering well from the anesthesia and that their pain is well-managed. Your vet will also prescribe pain medication for you to administer at home.
Post-Operative Care and Recovery
After a femoral head ostectomy, proper post-operative care and rehabilitation are essential for a successful outcome. Here’s what you can expect during the recovery period:
Immediate Post-Operative Care
- Pain management: Your vet will prescribe pain medication to keep your pet comfortable. Administer the medication exactly as directed.
- Wound care: Follow your veterinarian’s instructions carefully for caring for the incision. Keep the area clean and dry to prevent infection.
- Restricted activity: In the days immediately following surgery, it’s important to limit your pet’s activity to allow the surgical site to begin healing.
Rehabilitation and Exercise
Rehabilitation exercises play a crucial role in regaining strength and mobility.
- Passive range-of-motion (PROM) exercises: Gently move your pet’s leg through its full range of motion several times a day, as tolerated. This helps prevent stiffness and improve flexibility.
- Gradual increase in activity: Slowly increase your pet’s activity levels to rebuild muscle strength. Encourage activities like walking, gentle stair climbing, and even water walking (if your pet enjoys it).
- Controlled weight-bearing: Encourage your pet to put some weight on the leg as soon as possible after surgery. Start with short, frequent walks and gradually increase the duration and intensity.
Timeline for Recovery
Recovery timelines can vary depending on the individual animal and the extent of the surgery.
- Initial healing phase: For the first 30 days, avoid rough play and sudden movements. Focus on gentle, controlled activity to allow the tissues to heal.
- Long-term recovery: Most cats regain near-normal function within about six weeks. Dogs typically start to touch their toes to the ground within 10 to 14 days and bear partial weight on the leg within about three weeks.
What are the potential complications and long-term considerations?
Like any surgery, FHOs come with risks. The most common complications include:
- Decreased range of motion in the hip
- Muscle loss (atrophy) in the affected leg
- Shortening of the leg
- Infection
Careful post-operative rehabilitation, including physical therapy exercises, can significantly reduce the risk of these complications. It’s also critical to follow your veterinarian’s instructions meticulously.
The long-term prognosis for most pets undergoing FHO is good. Most experience significant pain relief and improved mobility. However, some degree of lameness may persist, especially after strenuous activity. Even with some lameness, most animals are far more comfortable than they were before the surgery.
What are the alternatives to FHO surgery?
If your vet recommends a femoral head ostectomy for your dog, you might want to ask about other options. These may include:
- Total Hip Replacement (THR). In THR, the surgeon replaces the entire hip joint.
- Triple Pelvic Osteotomy (TPO) and Juvenile Pubic Symphysiodesis (JPS). These surgeries may help young dogs with hip dysplasia.
The best procedure for your dog depends on your budget, their age and size, and how serious their condition is.
Wrapping Up
Femoral head ostectomy (FHO) surgery can be a real game-changer for pets who are suffering from hip pain and limited mobility. It’s all about getting them back on their feet and enjoying life again.
But remember, a successful FHO isn’t just about the surgery itself. Proper post-operative care and rehabilitation are absolutely essential. Following your vet’s instructions carefully will give your furry friend the best chance at a full recovery.
If you think FHO might be the right choice for your pet, talk to your veterinarian. They can evaluate your pet’s specific needs and help you decide on the best course of action.