FEMORAL HEAD AND NECK OSTEOTOMY
(FHO)
General Information:
This is a commonly performed surgery that is usually
regarded as a salvage procedure (it is used a means to elevate
pain and restore reasonable function to a dysfunctional joint
and leg). Dysfunction of the coxofemoral (hip) joint may result
from trauma (fractures and luxations), degenerative disease (hip
dysplasia) or any other condition in which normal blood flow or
development is impaired.
Cats and small dogs (less than forty pounds) generally
do very well following FHO. The more muscular and active the animals
is, the better the prognosis for an acceptable return to usage.
Overweight animals have a much more difficult time with rehabilitation
following FHO.
Surgical Procedure:
In this procedure, the head and neck of the femur
(large bone in upper leg or thigh) is literally cut away and removed.
The remaining joint space will gradually fill with a very dense,
fibrous scar tissue. This dense tissue will provide a type of
padding between the hip and the femur, thereby allowing for generally
pain free movement of the affected limb. Pain is caused when bone
grinds upon bone, this procedure tends to elevate pain by providing
a padding material between the two bone surfaces.
Rehabilitation:
Vigorous exercise after FHO is extremely helpful
in restoring muscle strength and function in the operated limb.
As soon as the sutures are remove, an organized program of physical
activity should be initiated.
Exercise should be started gradually and then increase
in intensity over several weeks to months. During the first week
of the program, you should exercise your pet for approximately
5 to 10 minutes three times daily. As the animal gains strength,
the duration of exercise is gradually increased. Swimming is an
excellent exercise for rehabilitation. If this is not feasible
then light walking and mild running will do fine, but should be
taken slower because of greater forces on the hip due to weight-bearing.
The earlier the limb is used and the greater the
range of motion it is put through, the better the limb will be
able to function more like "normal" after the healing
process. In order to allow early return to function, the
use of anti-inflammatory medication and pain medication is advocated.
If any other complicating factors like pelvic or
leg fractures are involved, then these rehabilitation recommendations
may not apply, see specific recommendations below.
Complications:
One must remember, this is a salvage procedure. The
"normal" joint has been disrupted and a false, scar
tissue joint has replaced it. You should not expect your pet to
perform as well as before.
Some potential complications include:
- Muscle atrophy or loss - may be prevented by a
good exercise program.
- Shortening of the operated limb - unpreventable
due to muscle and tendon contraction.
- Lameness or difficulty climbing stairs - more
common in larger dogs.
Some lameness is expected and it may worsen after
excessive exercise and with aging. Use of anti-inflammatory medication
will greatly help with this complication.
Recommendations:
- Your veterinarian may recommend giving a pain reliever
by mouth 1-2 times daily for several days, then as needed for
long term pain control.
- Passive physical therapy should be performed
twice daily for the first week.
- Antibiotics may being sent home with your pet
to ensure no infection occurs at the surgical site.
We hope that you will find this information helpful in your quest
for better pet care. If you have any questions or comments, please call your
veterinarian's office, or feel free to
e-mail us.
David E. Hammett, DVM
and the Staff of All Creatures Veterinary Clinic, PC
