This study evaluated total hip replacement arthroplasty (THRA) combined with a double-chevron subtrochanteric osteotomy for the treatment of neglected highly dislocated hips in adults.

Six cases treated with THRA combined with a double-chevron subtrochanteric osteotomy under the diagnosis of a neglected highly dislocated hip (Crowe classification IV) from April 1997 to October 2001 were followed up for between 21 months and 75 months. Harris hip scores, leg length discrepancy pre and postoperatively, osteotomy site union and implant loosening were chekced.

The average Harris hip score increased from 61 points preoperatively to 94 points postoperatively. The average leg length discrepancy was decreased from 6 cm preoperatively to 1.8 cm postoperatively. Bone union of the osteotomy site was obtained at 4 months after surgery. The radiographs showed no acetabular and femoral loosening sign at the latest follow up.

According to the clinical and radiological assessments, THRA combined with doublechevron subtrochanteric osteotomy gave satisfactory results in adults with a neglected highly dislocated hip in adults on a midterm follow up.