Femoral Head and Neck Ostectomy (FHO)
Canine Hip Dysplasia is an abnormal formation of the hip socket that, in its more severe form, can eventually Radiograph (X-ray) of a dog with severe degenerative joint disease secondary to hip dysplasia.cause crippling lameness and painful arthritis of the affected joint. In affected dogs, there is laxity present between the femoral head and acetabulum resulting in incongruency of the joint. This subluxation causes soft tissue damage, severe cartilage erosion and boney malformation resulting in osteoarthritis and degenerative joint disease. Degeneration of the cartilage can progress to complete cartilage loss resulting in bone on bone contact. The elimination of a smooth gliding surface and the exposed nerve endings within bone make this an extremely painful condition. Varying treatment options exist depending on the patient’s age, comfort and activity levels, and stage of degeneration of the hip joint. Once end stage degeneration occurs surgical treatment options are limited to a total hip replacement and a femoral head and neck ostectomy.
An FHO is often advised for end-stage or severe CHD. In this procedure, the painful arthritic or dislocated hip joint is removed eliminating the bone on bone contact. Fibrous tissues and the remaining joint capsule help hold the limb in place and a psuedoarthrosis (false joint) replaces the pre-existing hip joint. This procedure is generally regarded as most effective in smaller patients; however no definitive size limitation exists.
With appropriate patient selection and post operative physical therapy the outcome for patients receiving an FHO can be very good. Though the procedure does not give them a “new hip”, it does allow a for more comfortable range of motion. Outcome and success of this procedure is largely dependent on the severity of the condition pre-operatively and rehabilitation performed following surgery.
FHO For The Treatment of Trauma:
In some circumstances an FHO can also be used as treatment for severely fractured acetabular (hip socket) injuries, femoral head and neck fractures or luxations. This procedure may simplify repair and recovery in patients following severe trauma especial if multiple other injuries exist.
The radiograph below and on the left shows a patient with a right acetabular fracture (hip joint on the right side of the picture) An FHO was performed (radiograph on the right) and the pelvis went on to achieve boney union.