Blooming flower emerging from a surgically repaired hip joint, symbolizing healing and renewed mobility after hip dysplasia surgery.

Hip Dysplasia Breakthrough: Rebuilding Neglected Hips for a Pain-Free Life

Beau Callahan in Health & Wellness December 2025 • 4 min read.

"Discover how total hip arthroplasty with subtrochanteric shortening osteotomy is transforming the lives of adults with neglected developmental dysplasia, offering a path to renewed mobility and lasting relief."

Untreated developmental dysplasia of the hip (DDH) can lead to early osteoarthritis, causing significant pain and disability. While total hip reconstruction stands as the primary option, the unique challenges posed by DDH require specialized approaches to ensure successful outcomes.

DDH results in severe structural changes, affecting both the bony anatomy and the surrounding soft tissues. These changes include a shallow acetabulum, insufficient femoral head coverage, and muscle contractures. Careful evaluation of these factors is critical before proceeding with surgery.

This article explores the innovative surgical technique of total hip arthroplasty combined with subtrochanteric shortening osteotomy, offering renewed hope for individuals with neglected DDH. We will delve into the morphological changes associated with DDH, the importance of pre-operative evaluation, the surgical procedure itself, and the potential complications and outcomes.

Reconstructing the Hip: A Step-by-Step Solution

Blooming flower emerging from a surgically repaired hip joint, symbolizing healing and renewed mobility after hip dysplasia surgery.

The goal of total hip arthroplasty in DDH is to restore the hip's natural anatomy by placing the acetabular component at the level of the true acetabulum. This often requires a subtrochanteric shortening osteotomy, a procedure that involves:

Subtrochanteric shortening osteotomy is a demanding technique, but when successful, it can provide remarkable functional capacity and implant survival. Key considerations include:

Soft Tissue Release: Releasing contracted tissues around the hip to allow for proper joint movement.
Acetabular Reconstruction: Reaming and preparing the true acetabulum to receive the acetabular component, often requiring bone grafting for stability.
Femoral Shortening: Performing an osteotomy to shorten the femur, correcting limb length discrepancy and reducing tension on the sciatic nerve.
Femoral Component Placement: Inserting the femoral stem into the prepared canal, ensuring proper alignment and stability.
Fixation: Securing the osteotomy site with plates and screws to promote healing and stability.

While various osteotomy and fixation techniques exist, the common aim is to achieve anatomical reconstruction of the hip while preserving the abductor muscles, crucial for hip stability and function. Meticulous surgical technique and careful attention to detail are essential to minimize complications and optimize outcomes.

A Brighter Future for Neglected Hips

Total hip arthroplasty with subtrochanteric shortening osteotomy offers a transformative solution for individuals with neglected DDH. By addressing the underlying anatomical deformities and restoring proper hip mechanics, this procedure can alleviate pain, improve function, and enhance quality of life.

While the procedure is technically demanding and carries a risk of complications, the long-term benefits of anatomical hip reconstruction far outweigh the potential risks. With careful patient selection, meticulous surgical technique, and appropriate rehabilitation, patients can achieve remarkable outcomes and regain their active lifestyles.

If you are living with hip dysplasia, talk to your orthopedic surgeon to determine if total hip arthroplasty with subtrochanteric shortening osteotomy is the right option for you. This innovative procedure may be the key to unlocking a pain-free, mobile future.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1302/2058-5241.1.000026, Alternate LINK

Title: Reconstruction Of Neglected Developmental Dysplasia By Total Hip Arthroplasty With Subtrochanteric Shortening Osteotomy

Subject: Orthopedics and Sports Medicine

Journal: EFORT Open Reviews

Publisher: Bioscientifica

Authors: Bülent Atilla

Published: 2016-03-01

Everything You Need To Know

What is total hip arthroplasty with subtrochanteric shortening osteotomy?

Total hip arthroplasty with subtrochanteric shortening osteotomy is a surgical procedure designed to address the structural abnormalities caused by untreated developmental dysplasia of the hip (DDH). This technique aims to restore the natural anatomy of the hip joint, thus alleviating pain and improving function for adults who have suffered from DDH. The procedure involves several key steps including releasing contracted soft tissues, reconstructing the acetabulum, performing femoral shortening using a subtrochanteric osteotomy, placing the femoral component, and fixing the osteotomy site. The significance lies in its ability to correct the deformities associated with DDH, providing these patients with a path to renewed mobility.

What are the causes and consequences of untreated hip dysplasia?

Developmental dysplasia of the hip (DDH) is a condition where the hip joint does not develop correctly. This can lead to a shallow acetabulum, insufficient femoral head coverage, and muscle contractures. If left untreated, DDH can result in early osteoarthritis, pain, and disability. Total hip arthroplasty is the primary surgical option for DDH, however, the existing morphological changes associated with DDH necessitate specialized approaches like subtrochanteric shortening osteotomy. The implications of neglecting DDH are substantial, including chronic pain, limited mobility, and a reduced quality of life, highlighting the importance of early diagnosis and effective treatment.

What is a subtrochanteric shortening osteotomy and why is it used?

Subtrochanteric shortening osteotomy is a specific part of the total hip arthroplasty procedure that addresses femoral deformities and limb length discrepancies often seen in DDH patients. The technique involves making an osteotomy to shorten the femur. This is done to correct the limb length, and reduce tension on the sciatic nerve. This procedure, along with acetabular reconstruction and soft tissue releases, is critical for achieving proper hip mechanics and stability. The implications of a successful subtrochanteric shortening osteotomy include improved range of motion, reduced pain, and a more stable hip joint, ultimately contributing to better function and a higher quality of life.

What are the key steps involved in the surgical procedure?

The main steps of the total hip arthroplasty with subtrochanteric shortening osteotomy procedure include soft tissue release, acetabular reconstruction, femoral shortening via osteotomy, femoral component placement, and fixation of the osteotomy. Soft tissue release helps to improve joint movement. Acetabular reconstruction involves preparing the true acetabulum. Femoral shortening corrects the limb length discrepancy. The femoral component is then placed, and the osteotomy site is fixed with plates and screws to ensure healing and stability. Meticulous surgical technique is crucial throughout each step. The significance lies in its comprehensive approach to restoring hip anatomy and function, thus minimizing complications and optimizing outcomes.

Why is pre-operative evaluation important before surgery?

Pre-operative evaluation is critical for assessing the severity of the anatomical deformities caused by DDH before undertaking the total hip arthroplasty with subtrochanteric shortening osteotomy. This evaluation helps in surgical planning and ensures that the appropriate techniques are used to address the specific challenges of each patient. Factors that must be considered are the structural changes that include a shallow acetabulum, insufficient femoral head coverage, and muscle contractures. Careful pre-operative planning can minimize complications and optimize outcomes. The implications of thorough pre-operative assessment include improved surgical success rates, reduced risk of complications, and ultimately, better functional outcomes and improved quality of life for the patient.