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What is Femoral Head Ostectomy - FHO

The ball component of the joint is called the femoral head and the socket component is called the acetabulum.  A femoral head ostectomy is a surgical procedure that involves removal of the femoral head.  The procedure is performed when hip joint disease results in continuing pain and other methods of treatment are not feasible or did not produce the desired results.  Diseases such as chronic arthritis secondary to hip dysplasia or trauma are examples which can result in continuing pain and necessitate a femoral head ostectomy for relief.  When the femoral head is removed, the pain from pressure on the joint capsule and the cartilage is relieved.  The patient forms what is called a pseudarthrosis, which is a fibrous (scar) tissue joint. 

The degree of limb use after surgery varies between patients from normal use to a continued limp.  Even if the patient does not return to normal use of the limb, they should be more pain free after surgery.  The larger the patient the less predictable the final result, but as a rule the patient will function much better after surgery than before.  Full recovery may require 6 months but most dogs are doing better sooner   

Postoperative care and physical therapy are extremely important for a favorable outcome.  Physical therapy may begin after sutures are removed (if your pet has skin sutures) and is very important for maximum return of limb use.  Passive flexion and extension of the hip joint after surgery is one form of therapy.  This is accomplished by gently moving the knee joint forward toward the head and then reversing the action moving the knee away from the head.  The forward and backward movement should be minimal initially and increase to maximum at the end of the therapy session.  Five to ten minute sessions 2 times each day is recommended.   

The best type of physical therapy for dogs is swimming (this is not recommended for cats).  The bathtub will suffice for small dogs but larger dogs need a pool or body of water.  Two sessions each day for 5-20 minutes per sessions is recommended.  One 20-minute session is acceptable.  Allow the patient to paddle in the water, which will exercise the limb and joint.  This will increase the range of motion, strength and patient's confidence in using the leg. 

Supervised exercise is recommended to encourage the patient to use the limb.  Initially slow short leash walks are recommended.  With time and increasing limb strength more vigorous exercise can be instituted such as jogging and running. 

The convalescent period with this surgery can be 3-6 months with larger breeds of dogs.  Do not become discouraged with your pet's progress too early, but please call if you are concerned or have questions.

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