Surgery in my dog? What should I do Femoral Head Osteotomy (FHO) or Total Hip Replacement (THR)?? This is the question from an email I received concerning a little dog with Legg Calve Perthes disease - a degenerative disease that affects the head of the femur, the long bone in the leg that attaches to the pelvis by the hip joint.
The owner has tried an alternative route to hope to avoid surgery. After 10 weeks of treatment another radiograph was taken to determine if the treatment was helping or not. The symptoms were improved and the little dog was using the leg however with a lowered range of motion and he was bunny hopping. On top of that the radiograph showed a bit more degereration of the femur. Surgery is going to be the only option at this point to help this little one year old pup live a somewhat normal pain free life. SO what type of surgery would I recommend.
The FHO is a Femoral Head Osteotomy and in hip dysplasia for a large dog it is considered a salvage procedure. Meaning it is not the surgery of choice there are better surgeries for the dog, especially when they weigh over 30 pounds which most dogs with hip dysplasia are double that weight or more. The procedure is simple it just removes the head of the femur or the attachment to the hip. They just saw it off. A new joint is formed by just the muscles of the hind legs, which in the case of hip dysplasia they usually are atrophied (much smaller). It is similar to how the shoulder blade is normally attached to the dogs body, by muscle alone, there is no physical joint there. For a little dog the problem is minimized just by the limited force of weight and biomechanics on the little dog. So an FHO is not as much of a problem if your dog is the correct weight for its size and is under 30 pounds. However it still may have some biomechanic issues as the leg will effectively be a little shorter and he range of motion may be a little restricted depending on the amount of scar tissue formed and how the muscles reattach to the pelvic girdle.
A Total Hip Replacement is just that it removes the entire hip area and replaces it with synethetic material. It usually takes a longer time to recover from this surgery as it is much more involved; however I have seen dogs bounce back very quickly after this surgery just as fast as some FHO’s, some walking on it the same day. Since it is a more complicated procedure it requires the expertise of an orthopedic surgeon. The results are usually very good. The leg is put back together the way it was intended just with a fake joint, which improves the biomechanics of the dog after the surgery. The major problems with this surgery are cost and recovery time in some dogs. It is the better choice.
For the dog from the email, it is a little 1 year old 10 pound dog, either surgery will work in this case. If the owners have the money and the availability of an orthopedic surgeon the choice would be the Total Hip Replacement; however because the dog is so small an FHO would not be that much of a compromise.
For an even more indepth look at the total hip replacement suregery check this site out - www.gcvs.com/surgery/total_hip.htm
fho, hip dysplasia, legg calve perthes disease, thr, total hip replacement