Femoral Head Ostectomy (FHO)
Meet Gus a 2.5-year-old British Short Hair. Isn’t he handsome!?
Recently poor Gus jumped from the kitchen bench and started limping on one of his hind legs. Despite resting at home, his limp was not improving and so his loving owner brought him in to see us. On Gus’s physical examination we found that he was very sore particularly around his left hip.
Pain associated with trauma such as this can be due to multiple reasons, from minor injuries such as sprains to more serious conditions such fractures or dislocations. Gus was given strict instruction to stay rested and was started on some pain relief for a few days to see if this would help. He began to feel better and was putting weight on the left hind leg, but he still had a very prominent limp and was not a 100% so he returned 2 days later for further examination.
Since Gus had not responded well enough to the anti-inflammatory medications the assumption was that his injury was more than just a sprain. As a result, Gus was admitted to hospital and x-rays of his back legs and hips were taken under anaesthetic. Gus was very brave during his stay and got lots of love from the nursing team who just adored his big, squishy cheeks!
Gus’ x-rays made us very suspicious of a fracture in his hips and so we emailed his x-rays for a second, expert opinion to our consultant orthopaedic surgeon. We work closely with consultant specialists so that we can provide the best diagnosis for our patients. These second opinions come at no additional cost to our patients and help us choose the best course of action for their care. The specialist confirmed Gus had managed to fracture both his hip joints!
This shows how important it is to do radiographs to find these nasty hidden injuries.
To fully understand Gus’ injury, we need to understand what a normal hip is like. The hip joint in a cat is like a ball and socket. The “ball” is the rounded top of the thigh bone, and the “socket” is the cup-shaped part of the pelvis. In a healthy cat, these fit snugly together, allowing smooth movement without pain. The bones are held in place by muscles, ligaments, and other tissues. When everything is working properly, the cat can walk, run, and jump with ease.
Gus had fractured not one, but both the balls in his hips! This had very likely happened because he had jumped from a height and the force of the impact had fractured both the joints.
These fractures cannot be repaired by resting or through pins, screws or plates because of their location and the inability to immobilise the joint. The treatment for these fractures involves the removal of the ball from the hip joint, creating a false joint and alleviating pain.
The procedure is known as Femoral Head and Neck Osteotomy (FHO).
“Femoral” refers to the thigh bone, and “osteotomy” means the surgical removal of bone.
As Gus had injured both hips, the decision was made to perform the initial surgery on the most painful side, the left hip first and allow time for healing before proceeding with the second side.
Gus was back on his feet 2 weeks post operation and presented for a check-up where it was found that the pain in his left hip had nearly completely improved but the pain in his right hip was more prominent and so it was time for his second procedure. We performed the same FHO procedure on his right hip and once again, within 2 weeks he was walking without pain!
Isn’t this incredible!? There are no hip joints anymore but still Gus is moving around pain free.
Due to the alteration of his hips, Gus’ gait will be different, and he may not be able to stretch his hips as well as he could before, however he should not experience any pain which was the entire purpose of this procedure.
Gus has been a star patient over the course of his treatment, and we are very proud of him and his family for their dedication to Gus’ treatment and recovery.
