Your veterinarian just told you that your dog needs orthopedic surgery. Now you’re facing a confusing array of options: TPLO, FHO, and other unfamiliar procedures. At Calistoga Pet Clinic, your Napa County animal hospital, we understand how overwhelming these decisions can be. Here’s what you need to know: TPLO (Tibial Plateau Leveling Osteotomy) and FHO (Femoral Head Ostectomy) are two completely different surgeries. Each addresses a different joint problem. TPLO repairs torn knee ligaments; FHO treats hip problems. Understanding what each procedure does, which conditions they treat, and what recovery involves will help you make informed decisions about your furry friend’s care.

The idea of surgery can sound pretty scary, but these procedures can make a world of difference for your pup. Many dogs who are limping, in pain, or having trouble getting around end up bouncing back to their happy, active selves after surgery and some rehab. Let’s take a closer look at these two common surgeries, so you’ll know which one might be right for your furry pal—and what to expect along the way.

Understanding TPLO Surgery

TPLO surgery addresses cranial cruciate ligament (CCL) injuries, which are extremely common in dogs. The CCL is similar to the ACL in human knees and provides stability to the knee joint. When this ligament tears, either suddenly or gradually through degeneration, the knee becomes unstable, painful, and prone to arthritis.

What Happens During TPLO

TPLO is a bit of a mouthful, but here’s what happens: your vet makes a curved cut in your dog’s shin bone and rotates the top part to change the angle of the knee. This new angle means your dog’s thigh bone won’t slide around anymore, so the knee stays nice and stable—even without the ligament.

The bone is held in place with a special metal plate and screws, and over the next few months, it heals in its new position. The torn ligament isn’t fixed, but the knee works just fine without it, thanks to the new setup.

TPLO is a pretty advanced surgery, so not every vet offers it. Many pups go to a board-certified surgeon or a specialty clinic for this one. The procedure usually takes one to two hours, and most dogs spend a day or two at the hospital before heading home.

Which Dogs Need TPLO

TPLO is usually recommended for bigger, active dogs—think pups over 40 or 50 pounds, or those who love to run and play. It’s also a good choice for dogs with partial ligament tears that might get worse over time. While TPLO can help dogs of all sizes, it’s especially helpful for those larger, energetic pooches who put a lot of stress on their knees.

Dogs with CCL tears show characteristic symptoms. These can include sudden or gradual onset of hind leg lameness, reluctance to put full weight on the affected leg, difficulty rising or jumping, and a “sitting funny” posture with the affected leg held out to the side. Swelling around the knee joint also occurs. Your veterinarian can diagnose CCL tears through a physical examination. 

TPLO Recovery and Outcomes

TPLO recovery takes time, but the results are usually great. Most pups start feeling much better in 2 to 3 months, though it can take 4 to 6 months for a full recovery. During this time, your dog will need to rest and take it easy—think leash walks only and hanging out in a small, cozy space.

Rehab is a key part of TPLO recovery. Many dogs do well with professional therapy like underwater treadmill sessions or special exercises. If formal rehab isn’t possible, your vet can recommend at-home exercises to help your pup regain strength.

The long-term outlook for TPLO is excellent. Most dogs get back to their usual activities with little or no limping. TPLO also helps prevent arthritis down the road, especially compared to leaving the injury untreated. Just keep in mind—if your dog tears one knee ligament, there’s a good chance the other one might go at some point, too.

Understanding FHO Surgery

FHO surgery is for hip problems, not knees. In this procedure, the vet removes the ball part of your dog’s hip joint. The body then forms a “false joint” out of scar tissue and muscle. It might sound a little extreme, but FHO can really help dogs with painful hips get back on their feet.

What Happens During FHO

During FHO, the vet takes out the rounded top part of the thigh bone that fits into the hip socket. This gets rid of the painful bone-on-bone rubbing that happens with hip problems. Over time, scar tissue and muscle fill in the gap, creating a new, pain-free joint that lets your dog move around much more comfortably.

FHO is what vets call a “salvage procedure.” It’s done when the hip joint can’t be fixed or saved. While it doesn’t bring the hip back to normal, it does get rid of pain and helps your dog move around again. FHO is less complicated than TPLO, and most experienced vets can do it—not just specialists.

FHO surgery usually takes about one to two hours, and most dogs go home after a day or two in the hospital. It’s generally less expensive than TPLO, since it doesn’t need special plates or equipment, but costs can still vary depending on your vet and where you live.

Which Dogs Need FHO

FHO is a good option for dogs with severe hip dysplasia that isn’t getting better with medicine. It’s also used for certain conditions like Legg-Calvé-Perthes disease (which affects the hip bone, especially in small breeds), hip fractures that can’t be fixed, hips that keep popping out of place, or really bad arthritis that just won’t quit.

Small and medium-sized dogs (usually under 40 or 50 pounds) tend to do best with FHO, since their lighter weight puts less strain on the new joint. Bigger dogs can still have the surgery and do well, but they might not get quite the same results as their smaller pals.

Dogs with hip problems may show symptoms, including hind leg lameness, difficulty rising from a lying down position, reluctance to jump or climb stairs, a “bunny hopping” gait in which both hind legs move together, decreased muscle mass in the hind legs, and pain when the hip is extended or manipulated. Your veterinarian will diagnose hip problems through a physical examination and X-rays that show the extent of joint damage.

FHO Recovery and Outcomes

FHO recovery can be tough at first, but most dogs do really well in the end. The first few weeks are the hardest, as your pup will have some pain and will need to figure out how to use their leg in a new way. Rest and good pain control are super important during this time.

Physical therapy is key for a good FHO outcome. Gentle range-of-motion exercises usually start just a few days after surgery to keep things moving and prevent too much scar tissue. As your dog heals, you’ll add in strengthening exercises to help them build muscle and get back to normal. Many dogs do great with professional rehab, but at-home exercise routines can work well, too.

Most dogs start putting weight on their leg within two to four weeks after FHO. Full recovery takes about three to six months, though some pups keep improving for up to a year. Smaller dogs usually bounce back the fastest, but even big dogs can get back to moving comfortably.

Long-term results depend on your dog’s size, weight, and how much effort goes into rehab. Small dogs often get back to their usual antics with little or no limping. Bigger dogs might have a slight limp, but they’ll still feel much better and enjoy a big boost in quality of life.

Key Differences Between TPLO and FHO

Knowing the main differences between these surgeries can help you figure out which one is right for your pup’s particular problem.

Different Joints, Different Problems

The biggest difference? TPLO is for knee problems—specifically torn ligaments—while FHO is for hip issues. These are totally different joints, so you can’t pick between the two for the same problem. The right surgery depends on which joint needs help.

If your dog has both knee and hip trouble, they might need both surgeries—but not at the same time. Your vet will help decide which one to tackle first, based on which joint is causing the most trouble.

Surgical Approach and Goals

TPLO is a reconstructive surgery that changes how the knee works so it stays stable, even without the ligament. The goal is to get your dog’s knee working as close to normal as possible. FHO, on the other hand, is a salvage procedure—it removes the damaged part of the hip and lets the body create a new, pain-free joint. The main goal here is to get rid of pain and help your dog move comfortably again.

Both surgeries work well when used for the right problems, but they take very different approaches. TPLO keeps the joint in place and works around the torn ligament, while FHO removes the damaged part and lets the body build a new joint out of muscle and scar tissue.

Recovery Differences

Both surgeries need a good chunk of recovery time, but the process is a little different for each. With TPLO, the focus is on letting the bone heal and slowly getting your dog back to normal activity. The hardest part? Keeping your energetic pup from overdoing it too soon! Rest and a slow, steady increase in activity are key.

FHO recovery is all about building muscle and teaching your dog to use their leg in a new way. The trick is to get your pup moving, even if it’s a little uncomfortable at first, and to keep scar tissue from building up too much. Starting rehab exercises early makes a big difference.

Cost Considerations

TPLO usually costs more than FHO, since it needs special equipment and a highly trained surgeon. FHO is less expensive, but it’s still a big investment. Remember, the most important thing is choosing the surgery that’s right for your dog’s specific problem—not just the price tag.

Pet insurance might help cover these surgeries if your dog’s condition started after you got the policy. Many vets also offer payment plans or work with financing companies to help make surgery more affordable.

Alternatives to Surgery

While TPLO and FHO are often the best long-term fixes, some dogs might do better with other options—especially if surgery is risky because of age or health issues.

Medical Management for CCL Tears

Dogs with partial ligament tears, tiny pups, or those who can’t have anesthesia might be able to manage without surgery. This usually means lots of rest, keeping your dog at a healthy weight, using anti-inflammatories and joint supplements, and doing some physical therapy. Some dogs do well with this approach, but many will eventually need surgery if things get worse.

Medical Management for Hip Problems

Hip dysplasia and arthritis can sometimes be managed with medicine and lifestyle changes for quite a while. This might include keeping your dog slim, using pain meds and joint supplements, doing physical therapy, and making things easier at home—like adding ramps instead of stairs. While this won’t fix the problem, it can help your dog stay comfortable and happy.

Other Surgical Options

For knee injuries, other options besides TPLO include lateral suture stabilization (which is less invasive but not as effective for big, active dogs) and TTA, which is similar to TPLO but uses a different method. For hip problems, there’s also total hip replacement, which gives a brand new joint but is much more expensive and needs a specialist.

Your vet will go over all the options with you, taking into account your dog’s condition, size, age, activity level, and your budget.

Making the Decision: What to Ask Your Vet

If your dog needs orthopedic surgery, it’s important to ask lots of questions and talk things through with your vet. Here are some good questions to get you started:

What are the risks and benefits of surgery versus medical management for my specific dog? What are realistic expectations for my dog’s recovery and long-term function? What does the recovery process look like day to day, and what will I need to do at home? What are potential complications, and how common are they? What happens if we don’t do surgery, and how will my dog’s quality of life be affected?

Don’t forget to ask about your surgeon’s experience, what the surgery and aftercare will cost, and whether your dog might need more procedures down the road. The more you know, the easier it is to make the best choice for your pup and your family.

Life After Orthopedic Surgery

Getting through orthopedic surgery and recovery can give your dog many more happy, active years. Lots of pups who have TPLO or FHO go back to hiking, playing, and enjoying all the things they love—without pain holding them back.

Keeping your dog at a healthy weight is super important after surgery. Extra pounds put more stress on all the joints, even the ones that have been fixed. Good weight management and the right kind of exercise will help protect your dog’s joints and keep them feeling their best.

Keep up with joint supplements and stick to reasonable activity levels for your dog. Swimming and gentle walks are great low-impact ways to keep muscles strong without stressing the joints. Try to avoid high-impact activities like jumping off furniture or making sharp turns, since those can be tough on healing joints.

Regular vet visits help keep an eye on your dog’s joints and catch any problems early. Your vet can tweak pain meds or suggest other treatments to keep your furry friend comfy as they get older.

Myos Pet wrote about the procedure here. Metlife also wrote about FHO surgery in this article.

FAQ About TPLO and FHO Surgery

Can my dog have both TPLO and FHO surgery?

Yes, dogs can potentially have both surgeries if they have problems in both knees and hips, though the procedures would not be performed simultaneously. Your veterinarian will prioritize which joint requires surgical intervention most urgently based on the severity of lameness, pain level, and impact on quality of life. Typically, the most severely affected joint is addressed first, with recovery completed before tackling additional problems. Some dogs do develop multiple orthopedic issues over their lifetime, particularly large breeds prone to both hip dysplasia and cruciate ligament tears.

How long will it take for my dog to walk normally after TPLO or FHO?

The timeline varies between the two procedures and among individual dogs. After TPLO, most dogs begin bearing some weight on the leg within days to weeks, with significant improvement by 2 to 3 months and full recovery by 4 to 6 months. After FHO, dogs typically start using the leg within 2 to 4 weeks, with noticeable improvement by 6 to 8 weeks and continued improvement for 3 to 6 months or longer. Smaller dogs recovering from FHO often achieve better outcomes faster than larger dogs. Commitment to rehabilitation exercises significantly impacts recovery speed for both procedures.

Will my dog need pain medication long-term after surgery?

Most dogs do not require long-term pain medication after successful orthopedic surgery and complete recovery. During the initial recovery period, pain management is essential and typically continues for several weeks to months, depending on the procedure and individual response. As healing progresses, pain medications are gradually reduced and eventually discontinued. However, some dogs may benefit from pain medication during arthritis flare-ups, particularly in cold or damp weather, or as they reach senior years. The goal of both TPLO and FHO is to eliminate or dramatically reduce chronic pain.

Are there risks of complications with these surgeries?

Yes, as with any surgery, complications can occur, though both TPLO and FHO have high overall success rates. Potential complications include infection at the surgical site, implant failure or migration (for TPLO), excessive or insufficient scar tissue formation (for FHO), delayed bone healing, damage to nearby nerves or blood vessels, and ongoing lameness despite surgery. Working with experienced surgeons, following post-operative instructions carefully, and committing to proper rehabilitation significantly reduce the risk of complications. Discuss specific complication rates with your veterinary surgeon.

Schedule an Orthopedic Consultation at Our Napa County Veterinary Clinic

It’s always stressful when your dog needs surgery, but good information can help you make the best decision with your vet. Whether your pup needs help with a sore knee or a painful hip, these surgeries can make a huge difference—especially when followed by good rehab and lots of TLC.

If you’re searching for a vet near me in Napa County for orthopedic concerns, Calistoga Pet Clinic can evaluate your dog’s lameness, discuss appropriate treatment options, and refer you to trusted orthopedic specialists when surgical intervention is recommended. Don’t let your dog suffer through chronic pain and limited mobility. Schedule an evaluation today, and let’s explore the best path forward for your furry friend’s comfort and well-being.

This blog is intended solely for informational purposes. Always consult with your veterinarian for proper medical advice, diagnosis, or treatment plan for your pet and follow their guidance.

If you want to find out more about our Napa County, CA pet clinic, visit our Service page here for an overview of our services. If you are a new customer bringing your pet in for wellness care, fill out a triage form here.