Femoral Head Osteotomy (FHO) for Dogs


What You Need To Know About Femoral Head Ostectomy (FHO)

When the hip becomes damaged, it causes chronic pain and reduces mobility. This is when we consider Femoral Head Ostectomy (FHO). FHO is a surgery that aims to create mobility to a damaged or diseased hip bone.

Surgery is done by removing the neck or head of the femur to relieve pain. The FHO is the last case situation when pain cannot be controlled or tolerated.


Procedure Specifics

Femoral head and neck ostectomy (FHO) procedure involve a normal ball and socket joint. The Femoral Head is the ball, and the acetabulum is the socket of the joint. The Femoral Head fits into the acetabulum and allows it to move freely.

The FHO procedure is when the ball portion of the hip (Femoral Head) and the attachment (neck) portion are removed from the rest of the femur. This removes the hip joint.

After the ostectomy, the body gradually forms a new hip. In the recovery period, the new hip forms new scar tissue. With the support from the surrounding muscles and joint capsule, the pain should be relieved.


4 Common Reasons for an FHO

Hip Dysplasia

Hip Dysplasia commonly occurs in large dog breeds and is the most common skeletal disease in dogs. This disease is caused by malformation of the ball and socket joint. The malformation leads to deterioration, arthritis, and loss of function of the hip.

Bad genetics and environmental factors are major causes of this disorder. Rapid weight gain, nutritional issues, and pelvic-muscle mass can also influence Hip Dysplasia.  

Signs of Hip Dysplasia can be seen as early 4 months and is most commonly identified at 8 to 12 months.


Arthritis is a common side effect of Hip Dysplasia due to the movement of the Femoral Head.  Stiffness and worsening pain in the joint calls for FHO.

Acetabular Fracture

Fractures of the acetabulum cause major pain and surgery may not be an option. FHO is a good option for treating acetabular fractures. and 75% of small animals with pelvic fractures recover without surgery.

These type of fractures are almost always a result of a major trauma accident. Diagnosis is done by physical examination and X-rays.

Legg-Calve-Perthes Disease

Legg-Calve-Perthes disease (Avascular or Aseptic Necrosis of the Femoral Head) is the condition in which the femoral head starts to degenerate. Causes of Legg-Calve-Perthes are unknown, but studies suggest it’s due to the lack of blood supply to the femoral head. Without the proper blood supply, the bone starts to die. This disease most commonly affects small dog breeds at the age of five to eight months.

Femoral Head Dislocation or Hip Luxation

Dislocation is the displacement of the femoral head from the acetabular socket. The dislocation can disrupt the joint capsule, as well as ligaments and bone. While this issue is most commonly caused by major trauma, Hip Dysplasia can influence dislocation. In some cases, restoration of the hip isn’t possible or is very expensive, so FHO is the best option.

Signs and Symptoms Your Dog Is Having Hip Problems

Most signs are obvious when it comes to hip pain and discomfort. It’s important to visit a veterinarian if your dog is suffering from any of these symptoms.

  • Decrease in activity or mobility
  • Decrease in range of motion (ROM)
  • Narrow stance
  • Lameness or limping in backend
  • Reluctancy to stand, jump, or any type of climbing
  • Stiffness and pain
  • Bunny hops
  • Loss of muscle mass in the thigh and overall weight loss

Is Your Dog Qualified For FHO

The best way to know if your dog is qualified for an FHO is by professional guidance. Some hip injuries may require a full hip replacement, while other times the injury is inoperable and requires FHO.

FHO is more common in older dogs. while younger dogs may have other surgical options, such as Triple Pelvic Osteotomy (TPO), or Juvenile Pubic Symphsiodesis (JPS). There are many other factors to take into consideration, such as age, size, weight, and even breed.

What To Expect And Getting Ready For FHO

You can expect around a 3 to 4 months for full recovery. Physically rehabilitation will be in order, and keeping a close eye on your dog the first few weeks post-FHO is important.

Getting Ready

Getting your dog ready for FHO is pretty straightforward.

Fasting For Anesthesia

Just like in humans, dogs have to fast in preparation for anesthesia. This is because anesthesia limits the swallowing reflexes and if your dog is to vomit it causes serious risk. Your dog may be exempt from this if they have diabetes or low energy levels.

Prepare Medication And Food

See if you can give any medications on the morning of the operation. You may also be advised to drop off your dog’s food if they’re staying overnight.

Your dog may also require a special diet post-FHO. If this is the case, it’s best to prepare in advance.

Prepare Your Home

You will need to confine your dog either to a small space or kennel. Be sure to prepare this space before you bring your dog home from their FHO. Limiting space for your dog reduces the risk of injury or accidents. You’ll want to keep them fairly confined the first few days after surgery.

Post-FHO Care

Properly caring for your dog post-FHO is essential to a healthy recovery. Tissues and muscles could be disrupted during the FHO, which take around 6 weeks for full recovery.

Under 1 Week

The first two days after the operation your dog won’t be moving around much. It’s common for them to experience discomfort, bruising and swelling. It’s important to check the affected area for excessive swelling or any signs of infection. A cone of shame is usually in order, to stop your dog from licking the area.

3 to 4 days after the FHO, your dog should have mobility. Short walks should be in order, for 5 to 10 minutes. This could just be outside to potty. While your dog is unattended, it’s suggested to keep them in a confined area. It’s easy for your dog to slip on slick floors or want to climb the stairs in your home. That’s why it’s important to supervise them while they roam around.

If your dog is still not using their leg much at this time, you should talk to your veterinarian about pain medication or other options.

2 to 3 Weeks

Weeks after your dog’s operation, it’s essential to walk your dog frequently for rehabilitation.  At this point, your dog should be using the operated leg, although intense physical activity should be avoided. That would be playing fetch, roughhousing, quick running. In these cases, your dog could fall and hurt themselves again.  It is okay for them to jog.

2 to 3 Months

2 to 3 months after the surgery, your dog should regain most functionailty and resume normal activity. How quickly your dog recovers can be dependant on their breed, weight, and energy levels. Fitter dogs tend to recover faster.

Recovered Osteotomy – Source

Complications That Can Occur With FHO

Complications with FHO are rare. Some complications that can occur are:

  • Nerve damage
  • Dehiscence (opening of the incision)
  • Infections or bleeding
  • Lack of range of motion

Most pets that require an FHO have good recoveries. Complications usually vary on how well you treat your dog post-FHO. This means making sure they don’t irritate the operated area, giving them proper exercise and rehab, and keeping your dog clean.

If you think your dog is having hip problems, it’s important to consult with your veterinarian for your dog’s health and wellness.