Rationale: Total hip arthroplasty (THA) concomitant with subtrochanteric femoral shortening osteotomy for Crowe type IV dysplastic hip has been reported. However, the combination of subtrochanteric femoral osteotomy and revision THA has only been mentioned in one case report.
Patient concerns: A 67-year-old female had a history of congenital dislocation of both hips.
Diagnoses: Right hip was diagnosed the aseptic loosening of THA with extremely high replacement of the acetabular component.
Interventions: Revision THA concomitant with subtrochanteric femoral shortening osteotomy using a cement stem was performed. Before the revision surgery, primary THA with subtrochanteric shortening osteotomy was performed on the opposite side. Regarding leg length, the actual leg length of the affected side was 9 mm longer, and the subjective leg length discrepancy was 45 mm shorter in the affected limb due to pelvic obliquity. Subtrochanteric osteotomy was performed with an amount of osteotomy equal to the amount of distal translation of the hip center to the original acetabulum.
Outcomes: As a result, pelvic obliquity improved, and the subjective leg length discrepancy disappeared after revision surgery.
Lessons: The combination of subtrochanteric femoral shortening osteotomy with revision THA resulted in a satisfactory outcome.