Total hip arthroplasty after McMurray's osteotomy.

Total hip arthroplasty (THA) was done as a secondary procedure after McMurray's osteotomy in 15 cases, with a time lapse of 14-132 months between the two operations. Marked improvement in pain and function was achieved in 14 cases, although hip stiffness was greater than that in primary THA cases. It was noted that delay in THA enhanced the operative difficulties and decreased the overall improvement obtained. No special femoral component was employed, and extensive soft-tissue dissection was carried out to obtain near-normal hip biomechanics to decrease the chances of long-term loosening. Marked medullary canal distortion was encountered in eight cases. In spite of this, there were no cases with femoral shaft fractures. Trochanteric osteotomy should be employed in cases in which the canal is severely distorted. In these cases, routine antibiotic prophylaxis and adequate preoperative planning should be done.