In seventeen children with catastrophic loss of the femoral head, the
hip was salvaged by greater trochanteric arthroplasty. The average
follow-up of these patients was eleven years, and fourteen patients were
followed to skeletal maturity or longer. In Group I, consisting of four
patients with greater trochanteric arthroplasty alone, good initial
stability gradually deteriorated as subluxation occurred, accompanied by a
proportionate return of abductor limp, loss of hip motion, and an increased
rate of degenerative changes in the joint. Group II, consisting of eight
patients who had either acetabuloplasty or innominate osteotomy in addition
to greater trochanteric arthroplasty, had only slightly improved hip
containment and results similar to those in Group I. Spontaneous ankylosis
of the hip occurred in six of the patients in those two groups. The best
results were obtained in five patients in Groups III and IV who had the
procedure supplemented by proximal femoral varus osteotomy.