Femoral considerations for total hip replacement in hip dysplasia

THAin the dysplastic hip is a technically demanding procedure that requires careful preoperative planning. The common deformities associated with the dysplastic femur include hypoplasia, excessive neck anteversion, a valgus neck-shaft angle, metaphyseal-diaphyseal mismatch, and a posteriorly displaced greater trochanter. In selected cases, osteotomy of the femur may be performed to correct anteversion and/or avoid excessive leg lengthening and stretch of the sciatic nerve. All of these issues mandate careful preoperative planning. With the advent of modern surgical techniques and implants, the bone deformities in hip dysplasia can be successfully addressed and THA has proved to be a successful and durable operation.