This procedure is performed in some cases of hip dislocations, hip dysplasia, osteoarthritis, hip or femoral fractures and when there is a problem with blood supply to the femoral head/neck. These problems usually cause pain, lameness and restricted hip movement. It is classified as a salvage surgery, this means that it cannot be reversed. If there is an option for primary repair/fixation this would be preferable to FHNO, however, many other factors come into the decision making process such as finances, post surgery care, patient age, body weight, chronicity of the problem and previous unsuccessful surgeries.

First the diagnosis must be confirmed. Your vet will watch your pet walk and examine the hip joint. If your pet is in pain your vet may need to sedate or anaesthetise your pet to do a thorough examination. Radiographs are usually taken at this time to confirm the diagnosis, to rule out any other problems and for surgical planning.

Surgery involves removing the femoral head and neck with an oscillating saw. The formation of scar tissue results in a false joint called a pseudoarthrosis. The muscles and soft tissues surrounding the joint maintain movement.

While improved quality of life and comfort levels are expected following FHNO, all patients will have an altered gait, reduced joint motion and some muscle wastage after surgery. The outcome is better in cats and dogs weighing less than 17kg, however, larger dogs can still have improved quality of life following this procedure.

WHAT CAN GO WRONG?

Whilst the vast majority of procedures result in success, there are a number of potential complications that can occur. Every step possible is taken along the way to minimise the risk of complications and therefore maximise the chances of a good outcome.

Potential complications include: infection, lameness, limb shortening, muscle wastage, reduced hip movement and patellar luxation.

Aggressive pain relief and physical therapy (eg inclined treadmill, underwater treadmill, physiotherapy) will help maximise the outcome post operatively.

Once a dog/cat is confirmed as a surgical candidate, a date for surgery will be arranged. The timeframe for scheduling surgery will depend on the cause of the problem. Most dogs/cats are well enough to go home within 24 hours of surgery. We supply pain relieving drugs +/- antibiotics. Room rest is essential in the first six weeks with short lead walks for toileting purposes. Most dogs start to use the leg within a week of surgery and improve steadily thereafter. Physical therapy (see below) is mandatory and can be started before surgery or within the first week after surgery. Your vet will check your pet regularly in the first six weeks post surgery to ensure the wound heals uneventfully, remove any stitches (if present) and assess limb function. Please alert your vet or your surgeon sooner if progress is not satisfactory or if there are other complications. If all is going well at week six, short lead walks with a gradual increase in activity is advised. Your pet should have returned to normal activity by week 12 post surgery.

What you need to do BEFORE the day of surgery:

• Read the Post Surgery Care Instructions for Femoral head/neck excision osteotomy (link below).

• Organise at least one room (without furniture to jump on) to confine your dog. You may need to purchase gates and non-slip matting

• Arrange a skin check, and if necessary a blood test, 7-10 days before surgery. If your dog has any skin lesions, a medicated body wash and antibiotics may be prescribed. If skin lesions are found on the day of surgery, this may result in the procedure being rescheduled to a later date due to the risk of infection.

• Wash your dog the weekend or day before surgery. This will reduce the time spent under anaesthesia cleaning your dog on the day of surgery.

• Consider “enrichment” for your dog in the postoperative recovery period (eg stuffed toys, sniffing games, food dispensing toys, chewing and licking time etc).

• Arrange pre and post operative physical therapy appointments before the day of surgery as there may be a wait for an initial appointment and timing is of the essence in these cases (see physical therapy contacts below).

View, download or print these post surgery care instructions for femoral head and neck excision osteotomy.

Physio and rehab contacts list