FHNO
FHNO or Femoral head and Neck ostectomy is a surgical procedure commonly performed in dogs and cats of any size or age, when skeletally mature.
FHNO is a surgical procedure consisting of the excision (surgical removal) of femoral head and neck.
The goal of FHNO is to remove bone-on-bone contact and restore pain-free mobility to a diseased or damaged hip joint.
Some examples of FHNO indications:
Severe osteoarthritis
HD
Hip luxation/dislocation
Fractures involving the hip joint (for example comminuted acetabular fractures, femoral head/neck fractures) when primary repair is not achievable
avascular necrosis of the femoral head
The procedure is reserved for patients with devastating osteoarthritis of the coxofemoral joint that is unresponsive to conservative management and for which other surgical therapies are not an option.
Post op considerations:
Proper surgical techniques, adequate postoperative analgesia, and postoperative physical therapy are essential to maximize limb function. Many studies report better postoperative results in dogs weighing less than 20 kg
Excessive activity and high-impact motion should be avoided during the post-op period, but unlike other orthopedic procedures, after FHNO surgery restricted activity and cage rest are contraindicated. Patients should use the limb as early and as frequently after surgery, otherwise the fibrous tissue that forms during the postoperative period will restrict and limit range of motion of the coxofemoral joint. Therefore, physical therapy is critical to increase limb function in the postoperative period.
A faster healing period is expected from dogs that had normal function up until shortly before the FHNO, since chronic conditions often lead to muscle atrophy, which takes time to resolve. Most patients will show signs of complete recovery approximately 6-8 weeks post-operatively and will be able to return to their regular activity.
Sources:
Harper TAM. Femoral Head and Neck Excision. Vet Clin North Am Small Anim Pract. 2017 Jul;47(4):885-897.
