FHO Surgery in Dogs: Weighing the Pros and Cons

When it comes to addressing hip issues in dogs, one surgical option that often comes into the conversation is Femoral Head Ostectomy (FHO). Like any procedure, FHO comes with its set of advantages and drawbacks.

What is FHO Surgery?

Femoral Head Ostectomy involves the removal of the ball (femoral head) and neck from the hip joint, effectively eliminating the joint’s source of pain. The body then responds by creating scar tissue, which acts as a pseudo-joint, providing mobility without the bone-on-bone friction that causes discomfort.

Pros of FHO Surgery

1. Pain Relief

The primary objective of FHO is to alleviate pain. By removing the source of bone-on-bone contact, dogs typically experience significant relief from the discomfort associated with conditions like hip dysplasia or trauma.

2. Suitability for All Sizes

While traditionally recommended for smaller dogs and cats, FHO can also be an option for larger breeds. The outcome might vary, but many large dogs have adapted well post-surgery.

3. Cost-Effective

Compared to other surgical options like Total Hip Replacement (THR), FHO is generally less expensive. This makes it a more accessible option for many pet owners.

4. Quicker Recovery

Post-surgical recovery time is typically shorter with FHO compared to more invasive procedures. Many dogs start using their leg within a few days to weeks after the operation.

Cons of FHO Surgery

1. Altered Biomechanics

While FHO alleviates pain, it does alter the biomechanics of the hip. The scar tissue pseudo-joint doesn’t function exactly like a natural joint, which can lead to changes in gait or movement.

2. Potential for Muscle Atrophy

After surgery, there’s a chance of muscle atrophy due to reduced use of the leg during the healing phase. This might require physical therapy or exercises to rebuild muscle strength.

3. Not Always Predictable for Larger Dogs

Although FHO can be performed on large breeds, the outcomes are less predictable compared to smaller dogs. Larger dogs might face more challenges in adapting to the pseudo-joint, potentially leading to complications or the need for additional treatments.

4. Possibility of Post-Surgical Complications

Like any surgical procedure, there’s a risk of complications, including infection, nerve damage, or issues with the pseudo-joint formation. It’s essential to monitor the dog closely post-surgery and follow all veterinary care guidelines.

Long-Term Effects of FHO Surgery in Dogs

Improved Mobility and Pain Relief

Many dogs who undergo FHO surgery experience increased mobility and reduced pain over the long term. The formation of the pseudo-joint allows for movement without the bone-on-bone friction that initially caused discomfort.

Change in Gait

The structural alteration in the hip joint can lead to a change in the dog’s gait. Some dogs may develop a slightly different walking pattern, which is usually more noticeable shortly after surgery but often becomes less evident with time.

Muscle Atrophy

Without the natural joint’s biomechanics, some dogs might suffer from muscle atrophy, especially if post-surgical exercises aren’t practiced. This can result in reduced muscle mass and strength around the hip and upper leg region.

Before and After FHO Surgery


Dogs with severe hip pain or conditions like hip dysplasia often exhibit limping, reluctance to jump or climb stairs, and general lethargy.


Post-surgery, many dogs show a marked improvement in activity levels. With proper rehabilitation, many regain the ability to play, run, and jump, albeit sometimes with a slightly altered gait.

Failed FHO Surgery

In some instances, FHO might not provide the desired results. Factors leading to an unsuccessful outcome can include improper surgical techniques, inadequate post-op rehabilitation, or complications in scar tissue formation. In such cases, a second surgical intervention or alternative treatments might be considered.

Alternatives to FHO Surgery

Total Hip Replacement (THR)

THR is a more invasive procedure where the entire hip joint is replaced with prosthetic components. This option restores near-normal joint biomechanics and is especially recommended for larger dogs.

Conservative Management

For some dogs, non-surgical treatments like physiotherapy, weight management, and anti-inflammatory medications can help manage symptoms.

Dog Jumped After FHO Surgery

Jumping or engaging in high-impact activities soon after surgery can pose risks. It can lead to delayed healing, damage to the surgical site, or complications in pseudo-joint formation. Owners should monitor their pets closely and restrict such activities during the recovery period.

Complications of FHO Surgery in Dogs

While FHO is generally safe, potential complications include:

  • Infection: Any surgical procedure poses a risk of infection, which may require antibiotics or further treatment.
  • Poor Pseudo-Joint Formation: In some cases, the scar tissue may not form adequately, leading to decreased mobility or persistent pain.
  • Nerve Damage: Though rare, there’s a risk of nerve damage during surgery, which can affect leg function.

Dog Won’t Use Leg After FHO Surgery

It’s not uncommon for dogs to be hesitant in using the operated leg immediately after surgery. Causes can range from post-surgical pain, muscle weakness, or fear. Consistent rehabilitation, pain management, and patience are crucial in such scenarios. If the reluctance persists, a veterinary consultation is essential to rule out complications.


Q1: How is FHO different from a Total Hip Replacement (THR)?

Answer: FHO and THR are two distinct surgical approaches to address hip issues in dogs. While FHO involves removing the femoral head and neck to form a scar tissue-based pseudo-joint, THR replaces the entire hip joint with artificial components. THR aims to replicate the dog’s natural hip biomechanics closely, whereas FHO relies on the body’s ability to adapt and create a functional, albeit different, joint mechanism.

Q2: What post-operative care is needed after FHO surgery?

Answer: Post-operative care involves monitoring the surgical site for signs of infection, swelling, or unusual discharge. Dogs should have restricted movement initially to ensure proper healing, typically done using a crate or a confined space. Physical therapy or gentle exercises might be recommended to aid in muscle strengthening and optimal pseudo-joint formation. Regular check-ups with the veterinarian are crucial during the recovery phase.

Q3: Can older dogs undergo FHO surgery?

Answer: Age isn’t necessarily a strict limiting factor for FHO. Instead, the overall health and wellness of the dog play a more significant role. Many older dogs have successfully undergone FHO and experienced pain relief. However, their ability to heal and adapt might differ from younger dogs, so individual assessments are crucial.

Q4: Are there any long-term effects on mobility after FHO?

Answer: While many dogs regain near-normal mobility post-FHO, there can be variations in gait or movement due to the altered joint mechanism. Over time, most dogs adapt remarkably well, with the scar tissue providing adequate cushioning. Regular exercise and physical therapy can further aid in optimizing mobility.

Q5: Is weight a factor in the success of FHO surgery?

Answer: Weight can influence the outcome of FHO. Overweight dogs might face more challenges post-surgery due to the increased stress on the pseudo-joint. Achieving and maintaining an optimal weight is crucial for the best surgical outcomes and long-term joint health.

Q6: Are there conditions where FHO is preferred over other surgical options?

Answer: FHO might be the preferred option in cases where the hip joint is severely damaged due to trauma, certain infections, or when other surgeries like THR aren’t feasible due to cost or the specific anatomy of the dog. Additionally, for dogs with recurrent hip dislocations where other treatments haven’t been effective, FHO might be recommended.

Q7: Can both hips undergo FHO simultaneously?

Answer: While it’s technically possible to perform FHO on both hips simultaneously, it’s not commonly recommended. Doing one hip at a time allows the dog to rely on the untreated leg during recovery, making the healing process more manageable and less stressful for the dog.

Q8: How does FHO impact a dog’s lifespan?

Answer: FHO surgery primarily addresses pain and mobility issues related to the hip. It doesn’t directly influence a dog’s lifespan. However, improving mobility and alleviating pain can contribute to better overall quality of life, which can have indirect effects on a dog’s health and vitality.

Q9: Are certain breeds more suitable for FHO than others?

Answer: While FHO can be performed on any dog breed, it’s often more predictable in smaller breeds due to their lighter weight, placing less strain on the pseudo-joint. However, the procedure’s suitability isn’t strictly breed-dependent; individual health assessments play a vital role.

Q10: What’s the typical recovery time after FHO surgery?

Answer: Most dogs start to bear weight on the operated leg within a few days to a week post-surgery. Full recovery, including muscle strengthening and optimal mobility, may take anywhere from a few weeks to a few months, depending on the dog’s age, weight, and overall health.

Q11: Can complications arise after FHO surgery?

Answer: As with any surgery, complications can occur. Potential issues include infection at the surgical site, inadequate scar tissue formation leading to reduced mobility, and nerve damage. Regular post-operative check-ups can help identify and address any complications early on.

Q12: How do I know if my dog is a good candidate for FHO?

Answer: A thorough veterinary evaluation, considering factors like age, weight, general health, severity of hip damage, and previous treatments, will determine if FHO is the best option for your dog. Radiographs and other diagnostic tools can provide a clearer picture of the joint’s condition.

Q13: Are there non-surgical alternatives to FHO?

Answer: Yes, non-surgical treatments like physical therapy, weight management, joint supplements, and pain management can provide relief for some dogs with hip issues. However, the effectiveness of these treatments varies based on the severity of the condition.

Q14: How does FHO compare in terms of cost to other hip surgeries?

Answer: FHO is generally less expensive than procedures like Total Hip Replacement. However, costs can vary based on factors like the surgical facility, geographic location, post-operative care requirements, and any potential complications.

Q15: Is post-operative physiotherapy necessary after FHO?

Answer: While not always mandatory, physiotherapy can significantly benefit dogs post-FHO. It can aid in muscle strengthening, improve joint flexibility, and ensure a smoother transition to optimal mobility.

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