FHO: Femoral Head Removal
or Constructing a Natural "False Joint"

by Roger Ross, DVM

Femoral Head Ostectomy

This surgery is considered when the head of the femur bone is fractured or in cases of severe hip dysplasia: the leg remains functional and it stops the severe pain of the femur bone rubbing against the damaged hip socket.

This fancy sounding surgery is where we cut off the top inch or so of the femur bone so that it doesn't rub and grate on the hip bone. 

Possible reasons for needing to do this are severe damage to the pelvis or femora head, typical of being hit by a car or for advanced cases of arthritis of the hip joint.

Unfortunately, this surgery is often chosen instead of the much superior option of fixing a femur fracture or dislocation because the owner doesn't want (or can't afford) to pay for fixing the fracture.  Doing a femoral head removal costs a few hundred dollars.  Having a orthopedic specialist fix a shattered leg with surgical plates can cost several thousand dollars.  (A major reason to consider getting pet insurance)  On the other hand, it's a better option than leg amputation or euthanasia.

This works especially well in mid size and smaller dogs. It often works well for  large breed dogs too, but large breed dogs are more likely to have problems supporting their weight without an intact femur. 

The surgery certainly relieves pets of the agony of having their leg bone grind into a damaged or chronically inflamed hip socket with every step.  It's a little less likely to work out so well if both hip sockets are diseased, but's it's an option.

I do this surgery at our hospital, other vets like to refer to specialists for femora head removals.

Speaking of specialists...there are now physical therapists for pets in most states just like there are for human orthopedic patients.

The goal of the surgery is to form a "false joint", which leads to the formation of fibrous scar tissue around the rounded off bone end.  The hardened muscle or scar tissue then acts like a pivot and support point for the bone.

Once the surgery site has had time to heal (3-8 weeks) there is usually very little pain and enough support to get around, which is our goal.

Some injuries are so bad that a femoral head removal is the only reasonable choice even if you are willing to pay several thousand dollars for a specialist.

But there are alternatives to removing the femora head:

There are techniques where the joint is "fused" or "stabilized".

There are several possible stabilization procedures, including pinning the femoral head to the hip socket, changing where the muscle attachment occurs to a different site on the femur, toggle pinning the femoral head and several other techniques that are above my pay grade.

Total hip replacement is another option.

If an alternative stabilization technique doesn't work, femoral head removal or ostectomy still remains an option. You do end up paying for two surgeries if one of the other stabilization methods fail but if it does work, the outcome is better for your dog. 

On This Page:

Femoral Head Removal

Note; this page still in first draft ... I'll finish soon

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