Defining and Understanding Femoral Head Ostectomy (FHO) in Dogs

What Is It?

FHO is a surgical procedure where the femoral head, the ball of the hip joint, is removed. By eliminating bone-on-bone contact, the body forms a false joint made of scar tissue and muscle support. This reduces pain and restores comfortable function, especially in smaller or medium-sized dogs.

Who Gets It?

  • Dogs with severe hip dysplasia or traumatic hip injury that cannot be repaired.
  • Small to medium-sized dogs are the best candidates because they adapt well to the false joint.
  • In large or giant breeds, outcomes are less predictable but may still provide pain relief in selected cases.

Signs Owners May Notice

  • Persistent hip pain and stiffness.
  • Lameness that worsens with activity.
  • Difficulty rising or jumping.
  • Loss of thigh muscle mass on the affected side.
  • Reluctance to play, climb stairs, or exercise.

How Is It Diagnosed?

A veterinarian will examine the hip joint for pain, range of motion, and crepitus. Radiographs are commonly used to evaluate joint structure and confirm suitability for FHO. Referral to an orthopedic surgeon may be recommended for planning the procedure.

Why FHO?

FHO is often chosen when hip replacement is not available, not affordable, or not appropriate for the individual dog. By removing the painful femoral head, mobility and quality of life can be significantly improved without the need for implants. While it does not restore a completely normal hip, many dogs regain excellent function.

Why You Should See a Veterinary Surgeon

FHO requires precision to ensure proper removal and smooth bone edges. A veterinary surgeon will evaluate whether your dog is a good candidate, perform the procedure safely, and provide structured aftercare instructions to maximize recovery.

What Does FHO Involve? (High Level)

During surgery, the head and neck of the femur are removed. This prevents painful grinding in the hip joint. Scar tissue and surrounding muscles then form a false joint to support movement. Dogs usually recover well when combined with pain control, weight management, and rehabilitation.

Risks and Recovery Expectations

Potential risks include infection, incision complications, or poor false joint formation if rehabilitation is not followed. Most dogs need controlled activity and structured rehab after surgery. Smaller dogs usually return to good function, while larger breeds may retain some stiffness or reduced performance.

What Is Post-Op Like?

  • First 2 weeks: Strict rest with leash walks only for toileting. Cone must remain on to protect the incision. Bedding should be dry and supportive.
  • Weeks 3–6: Gradual increase in controlled walking. Gentle rehabilitation exercises begin with veterinary guidance.
  • Rehabilitation: Targeted strengthening of hip and thigh muscles is key for long-term success.
  • Long term: Many dogs achieve comfortable daily activity and play with minimal pain.

Benefits of Physical Rehabilitation

  • Pain relief: Gentle techniques support comfort and reduce muscle guarding.
  • Muscle rebuilding: Focused exercises strengthen hip and core muscles to stabilize the false joint.
  • Improved mobility: Rehabilitation helps restore stride and balance.
  • Owner involvement: Safe home exercises allow continued progress outside of sessions.

How to Help Your Dog at Home

  • Follow veterinary instructions: Activity restriction and incision protection are essential.
  • Controlled mobility: Use a harness and leash for support, block stairs and jumping.
  • Weight management: Keeping lean reduces strain on the false joint.
  • Comfortable bedding: Provide thick, supportive, dry bedding to prevent soreness.
  • Home setup: Add rugs or mats to prevent slipping on slick surfaces.

Tips for Success

  • Practice cone use early: Familiarize your dog with an e-collar before surgery.
  • Positive confinement: Train your dog to rest comfortably in a crate or pen before the procedure.
  • Gather supplies in advance: Have extra bedding, harness, and non-slip mats ready at home.
  • Rehab commitment: Stick with post-op rehab sessions and home exercise plans for best results.

Prognosis

Most small to medium dogs recover well after FHO, enjoying a comfortable and active lifestyle. Larger dogs may retain some reduced range of motion, but many still achieve meaningful pain relief and improved mobility when combined with rehabilitation and proper home care.