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Commonly Asked Questions Regarding Femoral Head Ostectomy (FHO)
 
What is the femoral head ostectomy (FHO) procedure?
Femoral head ostectomy is removal or excision of the ball portion of the hip joint. After removal, the bone is smoothed so there is no bone to bone contact occurring between the pelvis and the remaining portion of the femur. Removal of the portion of the femur that articulates with the hip joint then causes formation of a false fibrous joint.
 
What are the indications for FHO surgery?
Femoral head and neck excision or ostectomy is a salvage procedure used in the treatment and management of hip dysplasia, trauma, or other diseases of the hip. Hip dysplasia means malformation of the hip joints. It is the most common orthopedic disease in dogs, and a similar problem occurs in cats but much less often. The malformed hip will eventually develop some degree of arthritis and in some patients, pain. With trauma, patients can have fractures of the femoral head and often FHO surgery is indicated. There are other diseases of the hip, such as Perthes' Disease, where the blood supply to the femoral head is abnormal and causes aseptic necrosis of the femoral head. In instances like these, FHO surgery is indicated to remove the diseased portion of the bone
 
How do I make an appointment for my pet?
The figure illustrates the portion of bone that is removed during FHO
Appointments for an orthopedic evaluation are scheduled by referral only with the Orthopedic Surgery Service or the General Surgery Service (530-752-1393).
 
My appointment is not scheduled for several weeks. Can an appointment be made earlier?
  • Earlier appointments can be scheduled based upon the emergent, life-threatening needs of the patient. Hip dysplasia and other conditions that may necessitate FHO are not life threatening and therefore requests for earlier appointments often cannot be fulfilled. For more urgent circumstances, you must request to have the surgical resident on duty paged or may seek consultation with the general emergency service.

  • While hip dysplasia is a painful disease, most patients are effectively managed with crate rest and anti-inflammatory/anti-pain medication such as Rimadyl until the appointment time.

  • You may leave a message on our voice mail waiting list if you wish to be contacted if an earlier appointment becomes available.

  • You may also choose to consult with a private surgery referral practice. To locate a board-certified veterinary surgeon in your area log on to www.acvs.org.
 
What information should I bring to my appointment?
Bring a copy of the medical record and any pertinent radiographs (X-rays) associated with the problem. Your veterinarian should provide you with a copy of the record upon request. If possible, a cover letter summarizing the problem is appreciated. Medical X-rays are legally a vital part of the medical record that must be maintained by your veterinarian. Most veterinarians will loan the X-rays to you but these must be returned once the assessment is completed. X-rays that are left at the VMTH will be mailed back to your veterinarian.
 
What should I expect the day of my pet's exam?
  • A senior student will evaluate your pet followed by a consultation with the resident or faculty surgeon. The objective of the consultation is to review pertinent history, conduct a thorough general and orthopedic examination, review previous radiographs, obtain or repeat additional radiographs if needed, confirm the diagnosis, and discuss treatment options based on your pet's specific condition

  • The length of the appointment ranges from 1-6 hours depending on the need for sedation, additional diagnostics, and recovery from sedatives. Anticipate spending most of the day in Davis before your pet's evaluation is complete. We advise you arrange your schedule accordingly and bring books or materials to entertain yourself. Many clients will be seen in the morning and may be asked to return later following completion of the evaluation. Drop-off appointments are not available unless previous arrangements have been made.

  • Arrangements for the surgical procedure, if indicated, are determined at the time of the appointment. In general, surgery will not occur on the day of your appointment. Surgeries are generally scheduled to occur 1-2 days following your scheduled appointment. All patients undergoing anesthesia will be evaluated separately by the anesthesia service the day before the procedure.

  • Please anticipate leaving your dog for surgery. In general, we avoid consultation visits followed by surgery at a later date as this delays necessary surgery and makes scheduling more complicated.
 
How long will my pet be in the hospital?
Hospitalization of patients for FHO surgery typically ranges from 3-4 days including the day of the appointment, surgery, and recovery. In general, most patients are discharged 1-2 days after their surgical procedure but extended hospitalization may be required if there are complications.
 
What is the prognosis following surgery?
  • In general, femoral head ostectomy is highly successful in cats and small dogs (under 40 pounds). However, because this type of fibrous pseudo-joint is an unstable joint, clinical function is often unpredictable in larger dogs.

  • Recovery time may be relatively prolonged; often requiring 4-6 months before the dog is using the leg well.
 
What post-operative care is required after FHO surgery?
Post-operative care following FHO surgery is very different compared to most surgical procedures. Physical therapy is crucial to the success of the procedure. Swimming, running playing with other dogs, retrieving, etc is all encouraged starting 7-10 days after the operation. The fibrous false joint that will replace the hip joint will heal with a greater range of motion.
 
What are the complications or risks associated with FHO surgery?
Overall, complication rate associated with elective procedures is approximately 10-15%. Complications may range from mild and easily resolved, to more severe complications requiring further treatments or diagnostic testing.
 
Are any follow-up appointments required during the post-operative period?
In general, recommendations for suture removal are 10-14 days after surgery. Further recheck examinations When/how many? at your regular veterinarian or at the VMTH to assess progression of healing and encourage physical therapy to increase the range of motion within the hip joint.
 
What are the surgical and follow-up costs with FHO surgery?
See the Orthopedic Procedures Price List.




Prices subject to change without notice.

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