Related Experiment Video
Updated: May 22, 2026
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Total hip arthroplasty combined with double-chevron subtrochanteric osteotomy
Motoki Sonohata1, Tomonori Tajima, Masaru Kitajima
1Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan. sonohata@cc.saga-u.ac.jp
Background:
Subtrochanteric femoral shortening and corrective osteotomy are regarded as an integral part of total hip arthroplasty for a completely dislocated hip or severe deformity of the proximal femur. Alternative femoral osteotomy techniques-transverse, oblique, step-cut, and V-shaped, have been described.
Methods:
In this series, we performed 22 cementless total hip arthroplasties combined with double-chevron subtrochanteric osteotomies between 1997 and 2002. There were 17 females and 2 males. Their average age at the time of the operation was 59 years (range 41-74 years). Thirteen hips were completely dislocated, 8 hips needed treatment after a proximal femoral osteotomy, and there was 1 case of hip ankylosis.
Results:
The mean length of the operation was 128 min (range 80-215 min). Mean total blood loss was 1442 g (range 809-2007 g), which included both the intraoperative blood loss and postoperative blood loss. After an average of 7.6 years of follow-up, the Japanese Orthopaedic Association Hip Score improved from 48 to 79. Three types of complication were observed. There were 4 early dislocations, 3 proximal splits, and 1 nonunion at the osteotomy site.
Conclusions:
Our study shows that acceptable results are obtained from double-chevron subtrochanteric osteotomy for subtrochanteric femoral shortening and corrective osteotomy. However, total hip arthroplasty combined with subtrochanteric osteotomy is a technically demanding treatment option.