Oblique femoral osteotomy in cementless total hip arthroplasty. Prospective consecutive series with a 3-year minimum follow-up period.

Success of total hip arthroplasty using cementless implants is dependent on intimate contact of the prostheses with viable host-bone and achievement of optimal fit and rigid implant fixation. A technique of oblique femoral osteotomy has been used to correct proximal femoral deformity and to facilitate difficult revision surgery in selected cases. This prospective study included 26 osteotomies performed in 25 consecutive patients with a minimum follow-up period of 3 years. The median follow-up period was 50 months. Eighty-four percent of the reconstructions remained in situ at the final follow-up examination, with 81% of them rated clinically excellent or good. Three stems were revised for aseptic loosening at a mean interval of 46 months. One additional femoral revision was necessary for nonunion of the osteotomy. Two of the remaining stems were classified as radiographically loose. Although oblique femoral osteotomy serves as a useful adjunct surgical technique in difficult femoral reconstructions, nearly 25% of the hips in this study either failed or were loose at the medium-term follow-up examination. Long-term success of this technique with cementless prostheses remains to be defined.