Distal femoral shortening in total hip arthroplasty for complex primary hip reconstruction. A new surgical technique.

Successful total hip arthroplasty (THA) in congenital dislocated hips demands anatomical reduction in the normal center of rotation without overstretching the sciatic nerve and without excessive compression or abnormal forces across the joint. Proximal femoral and subtrochanteric shortening osteotomy has been described for THA for the treatment of dislocated hips. However, these osteotomies are demanding, associated with deformation of femoral canal and nonunion, and may increase the femoral stem stress. This study reports excellent results in 24 patients with a new surgical technique that combines THA with a distal femoral shortening in severely deformed hips using customized components.