Revision total hip arthroplasty with correctional femoral osteotomy in Paget's disease.

Varus alignment of the femoral component is associated with femoral component loosening in total hip arthroplasty performed for Paget's disease. Irregular and hemorrhagic bone, along with angular femoral deformity, was encountered during revision total hip arthroplasty in three pagetic patients. A diaphyseal femoral osteotomy facilitated cement removal and provided an opportunity for correction of the deformity. The step-cut configuration of the osteotomy provided intrinsic rotational stability of the femoral segments around a modular, long-stem cementless implant. Excellent clinical and radiographic results were achieved, but moderate blood loss and delayed healing of the osteotomy site were observed.