Total Hip Arthroplasty After Proximal Femoral Osteotomy: A Technique That Can Be Used to Address Presence of a Retained Intracortical Plate.

Total hip arthroplasty (THA) can be challenging in the setting of internal fixation devices previously placed in the proximal femur. When these devices are used in adolescent patients, endosteal hypertrophy can lead to significant bony overgrowth. Removal of these implants can result in significant cortical defects that may compromise the results of THA. This article describes a technique that can be used when a plate applied to the lateral femoral cortex has become "intracortical" as a result of extensive bony overgrowth. In using this technique to avoid plate removal, the surgeon eliminates the need for more extensive procedures aimed at compensating for deficiency of the femoral cortex in the area of plate removal.