[Total hip arthroplasty after proximal femoral osteotomy: 75 cases with 9-year follow-up].

Abstract

Indications for osteotomy must account for subsequent total hip arthoplasty. Implantation is difficult after subtrochanteric osteotomy which can cause important technical problems. The rate of failure is very high. The risk of femoral complications and misalignment of the femoral stem, irrespective of the type of initial osteotomy, is greater when the digital fossa lies medially to the diaphyseal axis. We prefer trochanterotomy or desosteotomy for such cases. Osteotomy did not rule out arthroplasty for any of the femurs. There were however important operative difficulties and the frequency of complications suggest we should be most prudent about careful preoperative planning in the frontal plane.