Indications for FHO Surgery

FHO is recommended in cases where hip joint disease or trauma leads to chronic pain, impaired mobility, and reduced quality of life. The procedure is indicated for:

• Canine and feline hip dysplasia (when non-surgical management fails)

• Femoral head fractures that are non-repairable

• Severe hip osteoarthritis or degenerative joint disease

• Legg-Calvé-Perthes disease (avascular necrosis of the femoral head)

• Hip luxation (dislocation) unresponsive to closed or open reduction

• Chronic pain from previous hip injury or malunion fractures

FHO is most effective in small to medium-sized dogs (under 50 lbs) and cats, as they adapt well to the formation of a fibrous false joint post-surgery. In larger dogs, outcomes are variable, with some requiring intensive post-op rehabilitation to achieve optimal function.

FHO Surgical Procedure

The goal of FHO surgery is to remove the femoral head and neck, eliminating joint pain caused by bone-to-bone contact. Over time, fibrous tissue and muscle support compensate for the missing joint, creating a pain-free pseudoarthrosis.

Surgical Steps

1. Pre-Surgical Assessment

   • Orthopedic examination to assess hip function and pain level.

   • Radiographs (X-rays) confirm femoral head degeneration, arthritis, or fractures.

   • Bloodwork and pre-anesthetic screening to ensure surgical safety.

2. Femoral Head and Neck Excision

   • A cranial or lateral surgical approach is used to access the hip joint.

   • The femoral head and neck are carefully excised using an oscillating saw.

   • Joint capsule closure and muscle realignment optimize soft tissue support post-surgery.

   • Post-surgical X-rays confirm complete excision of the femoral head and smooth bone edges to prevent impingement.

   • Immediate pain management strategies include NSAIDs, opioids, and adjunctive therapies.

FHO Post-Surgical Recovery & Rehabilitation

The success of FHO surgery depends largely on post-operative rehabilitation, as pets must retrain their muscles to function without a true hip joint. Unlike traditional orthopedic procedures, early post-op mobility is encouraged to prevent muscle contracture and stiffness.

Phase 1: Initial Healing (0-2 Weeks)

• Controlled activity: Short, frequent leash walks (dogs) or confined movement (cats).

• Pain management: NSAIDs, analgesics, and cold therapy to reduce inflammation.

• Passive Range-of-Motion (PROM) exercises: Gentle stretching to prevent stiffness.

Phase 2: Gradual Mobility (2-6 Weeks)

• Encouraged weight-bearing activities: Supervised short walks and gentle movement.

• Physical therapy integration: Hydrotherapy or laser therapy may accelerate recovery.

• Progressive strengthening exercises:

  Controlled movements to restore muscle mass.

Phase 3: Strength and Function Restoration (6-12 Weeks)

• Increased activity and endurance exercises.

• Normal movement returns as the pseudoarthrosis forms and stabilizes the limb.

• Final veterinary assessment to ensure pain-free function.

Most cats and small dogs return to normal activity levels within 8-12 weeks, while larger dogs may require extended rehabilitation to optimize long-term function.

Expected Outcomes & Prognosis

FHO surgery provides excellent pain relief and is well-tolerated in small dogs and cats, with over 90% regaining normal mobility. While range of motion is reduced compared to a natural hip joint, most pets regain sufficient function for daily activities, running, and jumping.

• Best outcomes are seen in pets that engage in early post-op rehabilitation and consistent physical therapy.

• Larger, more active dogs may experience gait abnormalities or mild limb shortening post-surgery

  but generally, adapt well over time.

• Weight control and muscle strengthening exercises are critical to maximizing long-term function.

Potential Complications & Considerations

While FHO is a highly successful procedure, complications can arise in certain cases, particularly if post-operative rehabilitation is insufficient.

Possible Post-Surgical Complications:

• Muscle atrophy due to delayed rehabilitation

• Restricted range of motion from scar tissue formation

• Persistent limb lameness in large or heavy dogs

• False joint instability or fibrous tissue impingement (rare)

Rehabilitation protocols, physical therapy, and proper post-operative care significantly reduce the risk of complications and optimize recovery outcomes.

Why Choose Canton Animal Hospital for FHO Surgery?

• Experienced Veterinary Surgeons – Skilled in advanced orthopedic procedures, including FHO for dogs and cats.

• State-of-the-Art Facilities – Equipped with modern surgical suites, imaging, and pain management options.