TOTAL HIP-ARTHROPLASTY WITH FEMORAL OSTEOTOMY FOR PROXIMAL FEMORAL DEFORMITY

Thirty-one total hip arthroplasties, 20 primary and 11 revision, combi ned with femoral osteotomy in 28 patients for a major proximal femoral deformity were reviewed an average of 4.6 years after surgery, The ty pe of femoral osteotomy used was a uniplanar wedge in 19 cases, biplan ar in 4, and step cut in 8, The Harris hip rating score improved from an average of 51 to 77 points in primary cases and from an average of 35 to 73 points in revision cases, The average time until union of the osteotomy was 35 weeks, Complications included intraoperative femoral fracture in 7 cases, osteotomy nonunion in 4, instability in 4, asept ic femoral loosening in 4, osteolysis in 1, and deep infection in 1, T en reoperations (32%) were performed in 8 patients, Total hip arthropl asty with concurrent femoral osteotomy is a technically demanding proc edure, Stable initial fixation of the osteotomy is recommended to avoi d osteotomy nonunion and failure.