What is a FHNE?
A femoral head and neck excision is a procedure that is intended to reduce hip pain in cases where other surgery is not appropriate. The procedure is used for some fractures of the femoral head or growth plate, hip luxation (that cannot be reduced),a failed total hip replacement and in the management of avascular necrosis of the femoral head (Legg-Calve-Perthes disease).
FHNE can be performed in all sizes and breed of dog and cat, but animals of smaller weight tend to have better outcomes following this surgery. Good candidates for FHNE include those who’s pain cannot be controlled by pain killers or other non-surgical means. It is usually considered a last resort to manage pain of the hip. Most cats and small dogs do very well with FHNE surgery and will be walking well after a month or two. Larger dogs may be candidates too but have more variable results after this surgery.
What does the surgery involve?
Preoperative radiographs are crucial to plan the surgery, as well as to make the correct diagnosis. The surgery involves using a special type of saw called an oscillating saw to remove the femoral head (the ‘ball’ of the ‘ball and socket’ joint). This reduces the bone-bone contact of the joint and therefore the pain associated with chronic disease or cartilage erosion.
Post operative care
It is important that your pet doesn’t lick the surgical site as this can cause infection. You might need to use an Elizabethan or inflatable collar to prevent this. Your pet will be given injectable pain killers around the time of surgery and will be discharged with oral pain killers. You should see your vet at 2-4 days postoperatively, 7-10 days and then at 3 weeks and 6 weeks.
It is common for your pet to be holding the leg off the ground at first, but with time their confidence should increase, and they should be using the leg well by 2 weeks postoperatively. Your pet should be trying to gently touch the toe down by 3-4 days postoperatively. The wound should be kept clean & dry; if it is swollen, hot or red then contact your vet. You can use cold compresses on the wound for the first 5 days.
- Week 1: Strict rest. Only going to the garden for toileting purposes. No stairs, jumping or running.
- Week 2: Stick to even flat ground, but you can allow controlled exercise on a short lead for 10 mins 2-3 times daily.
- Weeks 2-4: Your pet’s confidence should be increasing with only a mild limp at 4 weeks postoperatively – if this is not the case, please contact your vet.
- You can build up exercise on a short lead up to 20 mins 2-3 times per day.
- Avoid stairs for the first six weeks.
The prognosis is good to excellent for most cases, and most patients should be able to return to normal activity.
