Femoral Head Ostectomy (FHO) in Dogs & Cats: A Different Approach to Hip Pain

When owners hear that their dog has severe hip arthritis, many assume the only surgical option is a total hip replacement.

In reality, there is another procedure that has helped countless dogs regain comfort and mobility: the Femoral Head Ostectomy (FHO).

Unlike a total hip replacement, an FHO doesn't replace the damaged joint.

Instead, it removes the painful part of the joint altogether.

While that may sound surprising, many dogs can function remarkably well afterward.

What Is an FHO?

The hip is a ball-and-socket joint.

The "ball" is the femoral head—the top portion of the thigh bone.

During an FHO, the surgeon removes the femoral head and neck, eliminating the painful bone-on-bone contact caused by arthritis or injury.

Over time, the surrounding muscles and connective tissues form a "false joint" (fibrous pseudoarthrosis) that allows the leg to move comfortably.

Although this false joint isn't identical to a normal hip, it can provide excellent pain relief and functional mobility.

Which Dogs Are Good Candidates?

An FHO may be recommended for dogs with:

• Severe hip arthritis.
• Hip dysplasia with chronic pain.
• Femoral head fractures.
• Hip luxation (dislocation) that cannot be successfully repaired.
• Avascular necrosis (Legg-Calvé-Perthes disease).
• Failed previous hip surgery.

Historically, FHOs were recommended primarily for small and medium-sized dogs.

However, with dedicated rehabilitation, many larger dogs can also achieve very good outcomes.

The key is choosing the right patient and committing to postoperative rehabilitation.

What About Cats?

Cats are often excellent candidates for an FHO.

Because they are lighter, more agile, and naturally adapt their movement, many cats regain outstanding function after surgery.

For feline patients with severe hip injuries or arthritis, an FHO is often the preferred surgical option.

Recovery Is Everything

One of the biggest predictors of success isn't the surgery itself—it's the recovery afterward.

After surgery, pets need:

• Strict pain management.
• Controlled activity.
• Gradual return to movement.
• Physical rehabilitation.
• Muscle-strengthening exercises.

Unlike many orthopedic surgeries, early controlled use of the leg is encouraged once your veterinarian determines it's safe.

Building muscle helps the new fibrous joint function more effectively.

Dogs that remain inactive for long periods after surgery often have poorer outcomes than those participating in a structured rehabilitation program.

What Does the Research Say?

FHO has been performed successfully for decades.

Numerous studies have shown:

• Excellent pain relief.
• Improved mobility.
• High owner satisfaction.
• Good long-term quality of life.

While gait may not return completely to normal—particularly in larger dogs—most pets become far more comfortable than they were before surgery.

The procedure is especially successful in cats and smaller dogs.

FHO vs. Total Hip Replacement

Owners often ask which surgery is "better."

The answer depends on the patient.

Total Hip Replacement

• Replaces the normal joint.
• Usually restores more normal biomechanics.
• Often provides the best long-term function.
• More expensive.
• Requires specialized surgical training and implants.

Femoral Head Ostectomy

• Removes the painful joint.
• Creates a comfortable false joint.
• Less expensive.
• More widely available.
• Functional outcome depends heavily on rehabilitation and muscle development.

Neither surgery is universally better.

The best choice depends on:

• Your pet's size.
• Age.
• Activity level.
• Overall health.
• Financial considerations.
• Availability of a board-certified surgeon.
• Your veterinarian's recommendations.

Are There Risks?

Like any surgery, FHO carries potential risks, including:

• Infection.
• Delayed healing.
• Persistent muscle loss.
• Reduced range of motion.
• Continued lameness.
• Need for prolonged rehabilitation.

Fortunately, serious complications are relatively uncommon.

My Perspective

Continue learning

• Total hip replacement — the surgical alternative to an FHO.
• Exercise and physical rehabilitation — the single biggest predictor of FHO success.
• Arthritis medications for dogs and cats — pain control before and after surgery.
• Advanced arthritis treatments overview — compare every option side by side.