Great (Or Not So Great) Expectations with Femoral Head Osteotomy (FHO) Part (II)

 by Susan E. Davis, PT

You may be wondering how the dog can sit or walk after their femoral head osteotomy (FHO) without the firm contact of the femoral head in the socket. 

Image: enpevet Ltd
Initially, they will redistribute their position to bear weight more on the front limbs and other hind limbs.

This can lead to overcompensation so it is essential that physical therapy be started very soon after surgery to help the formation of a “false” fibrous joint.   

This is facilitated through an early range of motion and weight-bearing exercises.

The “empty” space fills in with soft connective scar tissue to form a new “pseudo” joint, which forms according to stimulation and stresses put onto it (Wolf’s Law) such as range of motion and weight shifting activities.

The veterinarian and physical therapist can show the dog owner how to do some home exercises, along with scheduled rehab sessions.  

This can start immediately after surgery or 10-14 days after surgery when the sutures are removed, depending upon the surgeon’s protocol.

If you choose to wait 2-3 months after surgery to “see how it goes” before deciding whether to try PT, it will be too late to maximize the formation of the fibrous tissue.

Along with early physical therapy exercises, you can apply moist warm heat packs to the hip to help bring blood flow into the region. 

Be sure to place a thin towel over the shaved area first, then the heat pack on top, to avoid burns. The temperature should be warm, not hot.

Plan for a quiet homecoming after surgery, especially if there are other pets in the house.  

Place carpets or non-skid runners over tile or wood floors to avoid your dog slipping.

Pillows can be placed in several locations on the floor where your dog normally likes to sit, to help them ease to and from the sitting position.

Avoid the use of stairs initially and use a leash with collar or harness for the stairs when the vet tells you to resume.  

Contact your vet for adequate medication for pain and inflammation, to allow your dog to handle the early exercises needed to maximize the formation of the “false” joint.

This new “pseudo” joint will not have the stability of a normal hip and running, jumping and hard playing may become somewhat limited. 

But you can expect your dog to resume walking with near-to full weight borne on the limb, for fair to good distances, and to enjoy a comfortable high quality of life.


Susan E. Davis (Sue) is a licensed Physical Therapist with over 30 years of practice in the human field, who transitioned into the animal world after taking courses at the UT Canine Rehabilitation program.  She is located in Red Bank, New Jersey.

She has been providing PT services to dogs and other animals through her entity Joycare Onsite, LLC in pet’s homes and in vet clinics since 2008.

She also provides pro bono services at the Monmouth County SPCA in Eatontown, NJ.  Sue is the proud “dog mommy” to Penelope, a miniature Dachshund with “attitude”.  For more information see her website , or follow on Twitter @animalPTsue.

Sue is also the author of a fantastic book on physical therapy, Physical Therapy And Rehabilitation For Animals: A Guide For The Consumer.  

Physical therapy can do so many great things for your dog. Understanding all the possibilities physical therapy can offer will change your dog's life. This book definitely belongs on the shelf of every dog lover.

Articles by Susan E. Davis:
Functional Strengthening Exercises: the What, Why and How
One Thing Leads To Another: Why The Second ACL Often Goes Too
Compensation: An Attempt To Restore Harmony
Paring Down to the Canine Core
Canine Massage: Every Dog ‘Kneads’ It”
Photon Power: Can Laser Therapy Help Your Dog?  
Physical Therapy in the Veterinary World  
Reiki: Is it real? 
Dog Lessons: Cooper  
The Essentials Of Canine Injury Prevention: 7 Tips For Keeping Your Dog Safer 
It's Not Just Walking, It's Therapy! 
Treatment And Prevention Of Canine Intervertebral Disc Disease (Part I)
Treatment And Prevention Of Canine Intervertebral Disc Disease (Part II Physical Therapy)
Range Of Motion: It’s A Matter Of Degree…
The Weight Of Water And How It Helps Dogs 
By Land or By Sea? A Comparison of Canine Treadmills 
Unraveling The Mystery Of Fascia And Myofascial Trigger Points (Part I)
Unraveling The Mystery Of Fascia And Myofascial Trigger Points (Part II) 
Scar Tissue: Is it Too Much of a Good Thing? 
Physical Therapy Tip Of The Month: Ramps! 
Physical Therapy Tip Of The Month: Indoor Duo Dog Exercises!
Physical Therapy Tip Of The Month: Best Practices After Your Dog’s Surgery

Further reading:
Femoral Head and Neck Excision

Related articles:
Great (Or Not So Great) Expectations with Femoral Head Osteotomy (FHO) Part (I) 
You Say Hip Dysplasia, I Say Knee Injury ... Forrest Gumbo's Story
From The Case Files: Hunter's Hip Dysplasia Was Nearly A Death Sentence
Hip Dysplasia Prevention And Treatment Options 
Hip And Elbow Dysplasia: Are They The Same Thing?
Just When You Thought You Knew Everything About Hip Dysplasia
Indy’s Struggle with Dysplasia


  1. Great advice, I'll have to share this with Bassetmomma as her Freddie has to have both hips replaced (he's only 2) - I wonder how the weight distribution works in this instance? (I think he's going to have one done first and then the other?)

    Wags to all

    Your pal Snoopy :)

    1. With a hip replacement, the distribution should get quite close to normal I'd think. Though it seems that nothing that has been altered gets its full original function, with the hip replacement it should be quite close.

  2. Oh my goodness! That looks INCREDIBLY painful. I had a hard time even looking at that first picture. But I do appreciate the process of therapy that the doctor is performing on the doggy.

    1. Well, not THAT much more painful than some other surgeries, such as the TPLO ... The main thing is, though, that it prevents horrible pain such a loose joint can cause.

  3. Oh my, this is too much for a cuddle. I hope my dog is not getting anything from the dog boarding long island that we go to.


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