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Total Hip Arthroplasty in Patients With Femoral Deformity
Deformity of the proximal femur creates unique challenges in primary THA. Factors that must be considered include anatomic and exposure issues, implant fit and fixation challenges, and stability concerns. The pertinent challenges to THA in patients with femoral deformity and a strategy to appropriately manage these challenges must be identified preoperatively to ensure a successful outcome. For example, failure to recognize coxa vara deformity and restore femoral offset may result in hip instability (secondary to laxity in the soft tissues) and/or increased leg length (required to achieve stability). This chapter reviews the surgical strategies for performing THA in patients with proximal femoral deformities, including deformities of the femoral neck, greater trochanter, and proximal femoral metadiaphysis. Indications for surgery, results, surgical techniques, and tips for avoiding complications are also presented.