Complex THA for Proximal Femoral Deformity


This is a highly active, healthy 40 year old female with a history of hip dysplasia. As a child, she had both pelvic and femoral varus derotational (VRDO) osteotomies. She was referred for THA by her original pediatric orthopaedic surgeon.


She underwent complex THA on right hip first.  An extended trochanteric osteotomy (ETO) was used on the femur to provide deformity correction and safe implantation of a modular tapered titanium stem. A femoral strut allograft was used posteriorly to fill in the void from the significant varus deformity correction.


The patient did well and resumed normal activity within 6 months. She proceeded with left hip reconstruction one year later. A similar ETO technique was used again on the femur, however a medial “wedge” osteotomy was necessary more proximally given the even more pronounced, extreme varus remodeling.


At 6 months after her left hip surgery, the patient returned to full, unrestricted activity without a cane.