FHO is the more commonly performed salvage procedure in cats and small dogs, while total hip replacement (THR) is the gold standard for coxofemoral disease in dogs and is increasingly available for cats. Both procedures are indicated for chronic coxofemoral osteoarthritis, fractures, luxation, and avascular necrosis of the femoral head; THR is additionally indicated for failed FHO.Journal of Feli…+2
For cats, FHO provides good clinical outcomes but objective gait analysis reveals measurable deficits. Cats after FHO show marked clinical gait changes, significantly reduced range of motion on the operated limb, pain with passive hip movements in the majority of cases, and hindlimb muscle circumference asymmetry consistent with limb unloading.Journal of Feli… Despite these objective findings, owners are consistently able to assess their cats accurately, and owner satisfaction remains acceptable.Journal of Feli…
THR produces superior objective outcomes in cats compared to FHO. Cats after THR show less lameness, no difference in range of motion between the operated and healthy limb, no pain with passive hip movements, and no significant difference in hindlimb muscle circumference.Journal of Feli… The Feline Musculoskeletal Pain Index (FMPI) score improves from 0.111 preoperatively to 2.111 postoperatively following feline THR, and owner satisfaction is rated "very good" in 90.9% of cases.Veterinary Surg… Available feline THR systems include the cemented BioMedtrix CFX Micro and Nano Hip systems, the Zurich Mini Cementless Hip Replacement System (Kyon), and BioMedtrix press-fit cups (BFX).Journal of Feli… The most common indication for THR in cats is slipped capital femoral epiphysis, occurring predominantly in young neutered male cats.Veterinary Surg… Median follow-up after feline THR is 752 days.Veterinary Surg…
In dogs, owner satisfaction after FHO is historically good to excellent for pain-free locomotion, but objective measurements tell a different story. FHO has been reported to carry a 42% incidence of unsatisfactory results at a mean of 4 years after surgery based on objective outcome measurements.Journal of the… Owner satisfaction following femoral head and neck excision is often good to excellent despite documented reductions in hip range of motion and hindlimb muscle mass asymmetry.Journal of the… Dogs under 20 kg have historically been associated with better long-term outcomes after FHO, though there is some disagreement between studies on this point.Journal of the… Early and aggressive postoperative physiotherapy improves limb function by preventing excessive pseudoarthrosis fibrosis, improving muscle mass, and maximizing range of motion.Journal of the… Late return to function is linked to significant muscle atrophy, patient obesity, and development of bony spurs causing undue bony contact between the pelvis and femur.Journal of the…
In dogs, THR achieves full return to function in 88.1% of procedures using a cementless press-fit system, with a median follow-up of 42 months.Veterinary and… The overall complication rate for cementless press-fit THR in dogs is 31.1%, broken down as catastrophic complications in 8.2%, major complications in 9.6%, and minor complications in 13.2% of procedures.Veterinary and… The most common complications are intraoperative femoral fissure, diaphyseal femoral fracture, and coxofemoral luxation, with the majority of complications occurring intraoperatively or perioperatively and few occurring beyond 12 weeks postoperatively.Veterinary and… For the cemented Micro THR system in small dogs and cats, 91% of procedures achieve excellent outcomes, with complications including prosthesis luxation, cup aseptic loosening, and sciatic neurapraxia; dogs under 2.75 kg are too small for the prosthesis.Veterinary Surg… The Zurich Cementless THR system is indicated for medium to giant breed dogs.Veterinary Clin…
When comparing pain outcomes specifically in dogs with hip dysplasia, both procedures reduce long-term pain, but THR is superior for return to normal function. Owner-reported absence of hip pain is achieved in 100% of FHO cases and 91–100% of THR cases across multiple studies, making direct pain comparison difficult; however, a systematic review supports THR as superior for returning dogs to normal function.Veterinary Evid…
FHO remains the appropriate choice when financial or logistical constraints preclude THR, and outcomes for acute versus chronic coxofemoral disease are similar in the long term following FHO in dogs.Journal of the…+1
| Procedure | Species | Key Outcome | Complication Rate | Caveat |
|---|---|---|---|---|
| FHO | Cats | Marked gait changes, reduced ROM, muscle atrophy on objective assessment; owner satisfaction acceptable Journal of Feli… | Not quantified in sources | Objective deficits persist despite owner-perceived improvement Journal of Feli… |
| THR (any system) | Cats | FMPI 0.111 → 2.111; 90.9% "very good" owner satisfaction; no ROM deficit vs. contralateral limb Veterinary Surg…+1 | 11/56 total complications, 9 major Veterinary Surg… | Median follow-up 752 days Veterinary Surg… |
| FHO | Dogs | Good–excellent owner satisfaction; 42% unsatisfactory by objective measures at mean 4 years Journal of the…+1 | Not quantified in sources | Better outcomes in dogs <20 kg; physiotherapy essential Journal of the… |
| THR cementless press-fit | Dogs | 88.1% full return to function at median 42 months Veterinary and… | 31.1% total (8.2% catastrophic, 9.6% major, 13.2% minor) Veterinary and… | Most complications intraoperative or perioperative Veterinary and… |
| Micro THR (cemented) | Small dogs & cats | 91% excellent outcomes Veterinary Surg… | Luxation, cup loosening, sciatic neurapraxia Veterinary Surg… | Dogs <2.75 kg excluded Veterinary Surg… |
| Zurich Cementless THR | Dogs | Effective for medium to giant breeds Veterinary Clin… | Not quantified in sources | Not validated for cats in this source Veterinary Clin… |
Would you like to go deeper on the postoperative physiotherapy protocol after FHO, or on patient selection criteria that favor THR over FHO in borderline cases?