Zee Mahmood, a veterinary technician in Reading, PA, contributed to this article.
The hip consists of a ball-and-socket joint. The ball (a.k.a. femoral head) is the top part of the femur or thigh bone. The narrow portion just below the ball is called the neck. The socket (or acetabulum) is the concave portion on each side of the pelvis.
A normal hip joint is held in place by muscles, a deep socket and strong ligaments. Several conditions of the hip can be corrected by a surgical procedure called a Femoral Head Ostectomy, or FHO.
Which conditions of the hip can be corrected by an FHO?
Hip Dysplasia--Hip dysplasia is caused by abnormal growth of the hip during puppyhood. Poor genetics is often the main reason. The abnormal growth results in looseness of the joint and arthritis develops, causing hip pain. This is can happen in dogs of any age, depending on how much they can cope with the signs. Signs can include:
Dislocation--Dislocation (or luxation) of a joint occurs after trauma. In the hip, the ball comes out of the socket. When the hip cannot or should not be placed back in its normal position, an FHO can be performed.
Fractures--Hip fractures can be severe enough that they cannot be repaired correctly. The FHO may then be the surgery of choice.
Legg-Calvé-Perthes disease--Legg-Calvé-Perthes disease causes the femoral head (the ball of the hip joint) to spontaneously disintegrate. The condition occurs when the blood supply to the head of the femur is inappropriate, causing the bone to soften. The weakened bone will fracture, ultimately collapsing the joint and resulting in a painful condition.
What are the signs of hip pain?
Signs that your dog may have hip pain are similar to those mentioned above. Decreased tolerance to exercise, stiffness, limping, or bunny hopping are some of the most obvious signs. Your dog should be seen by your veterinarian or a surgeon if you notice any of these signs.
An alternative treatment to some of the conditions above may be a total hip replacement. Although much costlier and more invasive, this option should be discussed with your veterinarian or surgeon, especially in large and giant breed dogs.
What is done during the FHO surgery?
The FHO surgery consists of removing the ball of the hip. The ligament around the hip is then stitched up. During healing, which usually takes two months, scar tissue will form in the joint to prevent rubbing of bone on bone. A "false joint" is then formed, which is pain free. The surrounding muscles also hold the hip in place.
After surgery, dogs are prescribed pain medications and antibiotics. Activity is highly restricted during the initial healing period, and a strict physical therapy program is recommended. This is extremely important to ensure a good range of motion in the affected hip. Most dogs will start using the surgery leg within two weeks.
Your veterinarian or surgeon should be notified if your dog is not using the limb after two to three weeks. Poor leg use and poor range of motion are classically due to less than adequate rehabilitation therapy. If you cannot do it yourself, you should seek the help of a professional doggy physical therapist (rehabilitation specialist). When both hips are affected, one surgery at a time is preferred, usually 2 months apart.
Prognosis is generally good following FHO surgery, provided that appropriate physical therapy has been performed. Most small dogs do very well following surgery. Large dogs also do well, but because of their increased weight, they may display weakness or stiffness in the affected leg. This is because the muscles around the hip and scar tissue are now supporting the dog's weight instead of an actual joint. The heavier the dog, the harder it is to predict the outcome. On the opposite end, the lighter the dog, the better they do after FHO surgery.
Questions to ask your veterinarian
- Is my dog a good candidate for an FHO?
- Who is the best person to perform the FHO?
- Can you recommend a good place for physical therapy?
If you have any questions or concerns, you should always visit or call your veterinarian -- they are your best resource to ensure the health and well-being of your pets.