There are a number of childhood conditions such as Perthes disease, Hip Dysplasia and Slipped Upper Femoral Epiphysis (SUFE) which can cause significant abnormalities in the immature hip. There are a variety of ways of treating these conditions but traditionally, they would have been treated with surgery to change the shape of the femur. The picture below shows an x-ray of the right hip in a 40 year old male who had undergone a previous valgus osteotomy. While it gave him relief for some years, he then began to get increasing pain in his hip. X-rays showed that arthritis had set in due to his abnormal anatomy.
These are difficult cases to manage surgically. Because of his previous operation, the shape of his upper femur made a normal hip replacement impossible. To get around this problem, the femur was split again and a corrective osteotomy performed. This allowed the use of a revision stem (s-rom) and a standard uncemented cup with ceramic bearings. While this was a major procedure, it did mean that normal anatomy was restored and the optimal bearings could be used.