Abstract:Objective To evaluate the manipulation technique and clinical outcome of total hip arthroplasty (THA) with no femoral shortening osteotomy for secondary shortened deformities in femoral head and neck. Methods Between August 2019 to March 2022, 19 patients (19 hips) with secondary shortened deformities in femoral head and neck were treated with THA, including 7 males and 12 females, with an average age of 37.6±3.2 years (range, 22 to 52 years), The primary diseases were suppurative hip arthritis in 9 cases, traumatic dislocation of the hip joint in 5 cases, and Legg-calve-Perthes disease in 5 cases. The THA were accomplished through posterolateral approach. First, the adhesion contracture of the hip capsule was dissected and released, the acetabulum was reconstructed or reconstructed after confirming the real position of the acetabulum. After the femoral stem test model was implanted, the short neck femoral head was placed for hip joint reduction. The soft tissue contracture around the hip joint was touched and released successively while maintaining the tension of the hip joint. The hip joint function and X-ray film were followed up regularly after operation to observe the prosthesis position and bone healing at the prosthesis - bone interface. The Harris hip score was used to evaluate the hip joint function. Results All of patients were followed up for 6-38months, average 21.5 years. No loosening or failure of component occurred,and the leg?length discrepancy of the bilateral sides and the pelvic obliquity was corrected gradually and the gait returns to normal by the end of follow-up. The Harris hip score was improved from preoperative 48.1±3.2 to 94.5±4.7 half year postoperatively, with significant differences (P<0.01). All prostheses acquired bone stabilization with no sign of loosening at 3 months postoperatively on X-ray. Conclusion For adult patients with severe secondary femoral head and neck shortening deformity, hip arthroplasty without femoral shortening osteotomy should focus on the effective release of bone and soft tissue around the hip joint. It is safe and effective to release the hip capsule and soft tissue contracture around the hip joint by layers.