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Femoral Head Ostectomy (FHO) Surgery in Dogs

Femoral Head Ostectomy (FHO) surgery can be an effective treatment option for hip problems in some dogs. Here, our Tracy vets explain causes and symptoms of some canine hip problems, and how FHO surgery can help to restore pain-free mobility. 

Why Your Dog May Have Hip Problems

Genetics, injury, old age or a combination of these three factors can contribute to hip problems in dogs. 

  • Typically, canine hip dysplasia is a genetic disorder. Hip dysplasia causes abnormal development in a dog's hip joints. 
  • Legg-Perthes disease is another condition that can impact your pooch's hips. The disease is marked by a lack of blood flow to the top of the femur, which causes spontaneous degeneration of the head of the femur and leads to hip damage and/or arthritis. 

While these conditions are relatively common, they can cause your pup to experience pain and mobility issues. To correct the problem, your veterinarian may recommend orthopedic surgery and refer you to a veterinary orthopedic specialist near  Tracy. 

How Your Dog's Hip Joints Should Work

A dog's hip joints work similarly to a ball and socket mechanism. The ball is located at the head of the thigh bone (femur) and rests inside the hip bone's acetabulum (socket part of the hip joint). 

When the hip is functioning normally, the ball and socket work together to allow easy, pain-free movement. However, disease or injury may cause deterioration and disruption to your pooch's normal hip function, leading to pain and mobility issues due to grinding and rubbing between the two parts. A poorly functioning or damaged hip joint can also lead to inflammation, which can reduce your pup's mobility and quality of life. 

For small dogs, Femoral Head Ostectomy (FHO) surgery may be able to ease their pain and restore their pain-free mobility. 

Hip Conditions in Dogs That May Benefit from FHO Surgery

Dogs with numerous hip conditions can benefit from FHO surgery. These conditions include:

  • Legg-Perthes disease
  • Hip fractures
  • Joint dislocation (luxation)
  • Severe arthritis 
  • Hip dysplasia
  • Weak muscles in hind legs

That said, this surgery is not suitable for all dogs. Your dog must weigh less than 50 pounds to be a candidate for FHO surgery. A smaller pet's weight will be an advantage in this scenario as the false joint that will form after surgery will be more easily able to support a smaller body compared to a larger or overweight dog. 

Signs That Your Dog May Have Hip Issues

Your dog may be suffering from a hip problem if they show one or more of the following symptoms:

  • 'Bunny hopping'
  • Limping when walking
  • Stiffness in joints
  • Decreased tolerance or motivation to exercise or play

FHO Surgery For Dogs

During the FHO surgery, the surgeon will remove the femoral head leaving the socket portion of the hip empty. Your dog's leg muscles will initially hold the femur in place as scar tissue develops between the femur and the acetabulum. Gradually over a period of time a “false joint” will begin to form and scar tissue will act as a cushion between the femur and the acetabulum.


FHO surgery is a relatively inexpensive procedure that can often help to restore pain-free mobility to smaller dogs. The cost of your dog's surgery will depend upon a number of factors so you will need to consult your veterinarian for an estimate.


Every dog is different. Following surgery, your pup may need to stay in the veterinary hospital for several hours or several days for post-surgical care. The duration of your dog's stay will depend upon your pet's overall health and a number of other factors. Recovery from FHO surgery usually happens in two phases:

Phase 1

In the days immediately following surgery, you and your vet will focus on controlling pain with medications such as prescription non-steroidal anti-inflammatory drugs. These will help reduce pain, inflammation and swelling at the surgical site.

Your dog should avoid strenuous physical activity for 30 days after surgery, and most dogs will require about six weeks to recover. Your pup won't be allowed to run or jump during their recovery period, however, you can take your pup for short 'on-leash' walks.

If your pet is not in too much pain, your vet may recommend passive range of motion exercises to encourage your dog's hip joint to move through its natural range of motion once again.

Phase 2

Approximately one week after the FHO surgery, the second phase of your dog's recovery begins and will involve gradually increasing physical activity so your pet can rebuild muscle mass and strengthen the hip joint.

Gradually increasing physical activity helps to prevent scar tissue from becoming too stiff, and will improve your dog's long-term mobility. Appropriate exercise in this phase may include walking upstairs independently, or walking on hind legs while you hold their front legs in the air.

After about a month, if your dog has recovered adequately, your pooch should be ready to resume regular physical activity. That said, high-impact activity should still be avoided at this time.

A mobility aid or dog lift harness may be useful throughout the Phase 2 healing process. Pets who were relatively active prior to surgery tend to recover more quickly thanks to the increased strength of muscle mass around the hip joint.

Caring For Your Pup After FHO Dog Surgery

Care requirements will vary depending on your dog’s individual circumstances and needs. If your pup does not fully recover within the typical six-week recovery period, formal physical rehabilitation therapy may be recommended. If your dog won't use the affected leg after the expected recovery period, seems to be in pain or is not doing as well as expected following FHO surgery, contact your orthopedic veterinary specialist right away.

Note: The advice provided in this post is intended for informational purposes and does not constitute medical advice regarding pets. For an accurate diagnosis of your pet's condition, please make an appointment with your vet.

Do you suspect your dog may have hip problems? Contact Paws and Claws Veterinary Hospital to book an exam and get a referral to a veterinary orthopedic specialist.

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