Panagiotis P Anastasopoulos1, Panagiotis Lepetsos2*, Nikolaos Baxevanos3, Nikolaos Liarakos3, Marianna Korre3, Anastasios Gketsos4

Total hip arthroplasty (THA) for the treatment of high congenitaldislocation of the hip is a complex and technically demandingprocedure. The difficulties encountered are due to the varietyof anatomic deformities seen in these patients. Morphologicalterations are seen in the acetabulum, femur and the affectedside of the pelvis, as well as the soft tissues. The main difficultyremains the restoration of the hip anatomy by recognizingthe true position of the acetabulum, implantation of theacetabular cup and the safe reduction of the prosthesis. This isconsidered essential in order to restore normal hip kinematicsand achieve patient satisfaction. Femoral shorteningosteotomies have been introduced to facilitate reduction,while avoiding the various complications that are caused byexcessive stretching of the soft tissues, such as nerve injuries.Different type of osteotomies have been described, that canbe used in the proximal, subtrochanteric or distal femur; eachhaving unique advantages and disadvantages. Familiarityis important in selecting and implementing the properprocedure. Furthermore, awareness of potential complicationsis imperative in avoiding pitfalls and improving outcomes andpatient satisfaction. This article reviews the various types offemoral shortening osteotomies that have been reported inthe literature and describes their features along with theirtechnical difficulties and disadvantages. Also reports ourexperience using the majority of those osteotomies.