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Postoperative Care Following
A Femoral Head & Neck Ostectomy (FHO)

A femoral head and neck ostectomy (FHO) procedure is performed in animals with intractable pain of the hip joint caused by many disease processes. Pain in the hip joint is often caused by the loss of articular cartilage that results in bone rubbing against bone. An FHO removes the femoral head and results in the formation of a pain-free, functional "false joint". The success of this surgery is dependant on the ability of the patient to develop this "false joint" and is directly related to several factors. These factors include the weight of the patient, muscle mass present around the hip prior to surgery, activity level of the patient, and physical rehabilitation.

Weight of the Patient

Generally, smaller patients have a better functional outcome following an FHO. Small dogs and cats routinely function without any gait abnormality or pain following an FHO. Larger dogs (greater than 40 pounds) often will have some degree of gait dysfunction; however, they are usually pain-free. This does not mean that large dogs cannot do very well with this surgery - just that the outcome may not result in a perfect gait. The reduction in pain should improve the quality of life in any sized patient.

Activity and Physical Rehabilitation

Activity is very important following this surgical procedure. Southeast Veterinary Specialists is extremely lucky to have a certified animal rehabilitation practitioner on staff. Robert Porter (Robby) is here to guide you through the process of physical rehabilitation after an FHO. Physical rehabilitation appointments with Robby are strongly recommended after an FHO. We understand that both time and finances may be limited; however, it is our opinion that aggressive rehabilitation can greatly improve your pet's function after surgery. After a short period of time (7 days) to allow for tissue healing after surgery, the patient should be encouraged to use the leg as much as possible. Leash walks at a slow pace encourage the animal to place the limb on the ground rather than carry it. Swimming is wonderful exercise and will encourage the animal to move the joint through a complete range of motion and develop the muscles of the hip region.
Range of motion exercises are relatively easy to perform and should be done at home. You should not begin these exercises until 7 days after surgery. Begin by massaging your pet's limb and getting him/her used to the manipulation. After several minutes, begin to move the hip through its full range of motion. Concentrate on reaching full extension and full flexion. If this is not possible or uncomfortable for your pet, do as much as you can and try to do a little more each day. This therapy should be performed for 10 to 15 minutes 2 to 4 times daily.

Medication

In most cases, a non-steroidal anti-inflammatory drug such as carprofen (Rimadyl®) or deracoxib (Deramaxx®) will be recommended. This class of drugs is often helpful in relieving postoperative inflammation, pain, and swelling. This will help your pet to be more comfortable and return to normal function sooner. Do not give your pet any other medication without consulting us. Many other non-steroidal anti-inflammatory drugs available for people are often toxic in dogs.
Antibiotics are usually used during surgery and may be considered postoperatively at home. Please do not give your pet any medication without discussing it with our office first. Antibiotics given inappropriately may result in the development of a resistant infection that can be difficult to treat.
Pain medication other than a non-steroidal anti-inflammatory drug may be needed in rare cases. If you feel that your pet is unusually uncomfortable, please notify our office. Uncontrollable pain is not an acceptable complication of surgery, and methods are available to keep your pet comfortable without side effects.

Sutures

External skin sutures, when present, should be removed in 7 to 10 days. In most cases the skin is closed with internal absorbable sutures which do not require removal. If you notice your pet licking and chewing the incision area, please notify us. Some swelling is normal after surgery; however, please call if you think the swelling is excessive or if you notice a discharge or foul smell from the incision.