Femoral Head Ostectomy/Removing the Ball off the Femur at the Hip Joint
First and foremost: pay attention to the discharge instructions your veterinarian has given you. During this surgery, there was cutting of muscle and other tissue that will require care and time to heal. You do not need to wrestle with your dog in order to apply ice to the surgery site; I no longer recommend icing nor prolonged use of anti-inflammatory medications after most surgeries or injuries in keeping with the advanced research findings over the past 5+ years.
While other tissues are also disrupted during a FHO, muscle requires a little over six weeks to achieve a normal collagen ratio and will take longer to heal more fully. This should be considered when you think your dog is ready to chase squirrels at two weeks after surgery. Don’t let them if you hope for the best outcome from the surgery. On the other hand, the bone that was cut does not require the same care that a fracture repair or a TPLO would; there is no need to be concerned that you will cause further damage to the bone with exercise.
In physical rehabilitation after FHO we should aim at keeping the “false” joint comfortable after surgery by promoting hip flexion and extension through therapeutic exercises that stimulate leg use, leading to muscle strengthening and avoiding chronic disuse of the operated limb. Since the dog will move as they are comfortable and are made more comfortable with the right amount of the right pain medicines, I DO NOT recommend pet owners try to do range of motion.
After about five days, and especially if your dog is not using the leg much, then I recommend you speak to your veterinarian about finding some additional pain control medications that will suit your dog. Recovery will improve if your pet feels less pain and is able to use their leg more “normally”, yet gently. Pain medicine along with the right kind of exercise at the right time helps achieve this, and it seems the medications are needed for an average of eight weeks for dogs after this surgery, if not more. No, as popular as it might be, your dog does not need a water treadmill workout to start walking again!
In light of this information, I believe the best outcome from surgery will be realized with a rehab consult from me to give instruction and homework specific to your pet. In-person consultation will always be better than the generic homework given over the internet. Otherwise, until I publish the booklet for specific post-op instructions after this hip surgery, please follow the first four weeks of work outlined in this book:
All of these exercises should be done very slowly so as to encourage more weight-bearing. When the dog goes too fast, he/she can “cheat” and not use the repaired leg much or well. Too fast could also prolong the inflammation and pain as well as create additional damage to the area of the muscle at the end of the femur hip and upper thigh muscles. Too fast and too much activity will elevate blood pressure and likely cause the blood vessels to open up inside…keep calm and allow the vessels at least two weeks to heal.
We hope to create a slightly and increasingly calloused area in the muscle tissue at the end of the modified/cut femur. This will make the tissue feel the end of the bone less and less and will create a cushion of sorts. You can do this with the moderate & slowly increased exercise I begin to outline in the book…slowly increased exercise…not randomly increased because you think he’s better and able each day…slowly according to the plan I’ve written or one similar that allows for adjustment and healing in the body. I write these words having worked hundreds of cases that were allowed to do too much too soon, and it’s much harder to heal under those conditions 🙂
Running & rambunctious play during this time will upset the scar tissue I want you to help your pet create. On the other hand, not enough exercise, which is usually the problem after this surgery, results in too much scar tissue all around the hip, and your pet will experience decreased mobility and more continuous pain, especially when she is technically at a point that she may play and be wild. I often see these dogs months after surgery and they are still not using the surgery leg well.
If your pet is not using the operated leg after week 1, then I recommend calling your veterinarian or me for rehab intervention and to get them started on beneficial exercise. Range of motion is not an exercise that will be most beneficial at this time. With proper pain control, with good pain medication, your pet should use the leg for the exercises I outline in the book and in the future. Water treadmill is also not necessary for recovery from this surgery. If you follow the exercise prescription well and after week 4 of work would like advanced exercises, then a rehab consult is necessary.
I have some separate recommendations for cat FHO’s .
© 2007 Deborah Carroll
Rehabilitation and Conditioning for Animals