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Femoral Head Ostectomy (FHO)


An FHO, or femoral head ostectomy, is a surgical procedure that aims to restore mobility to a damaged hip joint. By removing or excising the ball portion of the hip joint and smoothing the bone so there is no bone to bone contact occurring between the pelvis and the remaining portion of the femur, thus eliminating a majority of pain and discomfort in your pet. 

When the hip becomes damaged or diseased mobility can be affected. If the ball joint of the hip and the head of the femur do not fit together properly, the degree of movement that the joint can achieve is lessened. In addition, this poor joint fit can lead to chronic pain and inflammation.

An FHO restores mobility to the hip by removing the head of the femur. This removes the ball of the ball-and-socket joint, leaving just an empty socket. The muscles of the leg will initially hold the femur in place and, over time, scar tissue will form between the joint of the hip or acetabulum and the femur to provide cushioning that is referred to as a 'false joint'. Although this joint is anatomically very different from a normal hip joint, it provides pain-free mobility in most patients.

The primary goal of an FHO is to remove bone-on-bone contact, restoring pain-free mobility. The most common reasons for FHO include:

  • Fractures involving the hip. When a fracture involves the hip joint and cannot be repaired surgically an FHO may provide the best option for pain-free mobility.
  • Hip luxation/dislocation (associated with trauma or severe hip dysplasia). In some cases, a hip that is out of socket cannot be replaced with manipulation or other medical means. Surgical repair of hip luxations can be costly and is not always successful, so many dog owners elect FHO for small dogs with hip luxation.
  • Severe arthritis of the hip. In chronic, end-stage arthritis, the cartilage that protects both the head of the femur and the acetabulum can become eroded away, leading to painful bone-on-bone grating whenever the hip is moved. Performing an FHO can remove this point of contact and alleviate pain.
  • Legg-Perthes disease. This uncommon condition, most frequently seen in miniature and toy breed dogs, causes the bone within the femoral head to begin to die at an early age. The bone collapses due to these degenerative changes, leading to severe pain. Removing the femoral head via FHO removes the source of pain for the dog.

Hospitalization of patients for FHO surgery typically ranges from 2-3 days including the day of the surgery and recovery. In general, most patients are discharged 1-2 days after their surgical procedure.

Most dogs recover fully after FHO surgery and regain essentially-normal function of the affected leg. Although the leg may have a slightly decreased range of motion or decreased limb length after surgery, these impacts are typically minimal and do not impact the pet’s quality of life.