Total Hip Arthroplasty with Sub-Trochanteric Femoral Shortening Osteotomy for Post-Infective Hip Dysplasia-A Case Report

Total hip arthroplasty is a surgical option for patients with symptomatic arthritis secondary to severe hip dysplasia. These cases are associated with difficulty in identifying the true acetabulum and achieving stable fixation of the acetabular component is challenging. On the femoral side, femurs in dysplastic hip have increased anteversion, shorter femoral necks and reduced intramedullary canal size. The outcome of total hip arthroplasty in these patients improves with restoration of the anatomical centre of the hip. But restoration of the hip centre in a dysplastic hip can lead to excessive limb lengthening and traction nerve injury. So, additional femoral shortening is necessary to allow hip reduction and to avoid excessive limb lengthening. Sub-trochanteric femoral shortening osteotomy is therefore a viable option and can be extremely useful in addressing the limb length discrepancy, facilitate reduction, equalize limb lengths, and protect the sciatic nerve. We report a case of post-infective dysplasia of hip where sub-trochanteric femoral shortening osteotomy was done along with total hip arthroplasty.