Legg-Calve-Perthes disease (LCP) occurs due to idiopathic avascular necrosis of the femoral head during childhood. Some children, regardless of the treatment received in their youth, continue to develop early-onset secondary osteoarthritis, which may require total hip arthroplasty (THA). Total hip arthroplasty in young, short patients is a poorly described topic in literature. The limited availability of implants in some countries restricts treatment options and increases the complexity of the procedure. A 23-year-old female dental student, measuring 145 cm in height, presents with bilateral osteoarthritis secondary to Legg-Calve-Perthes disease, having undergone multiple surgeries on both hips since the age of 4. She seeks specialized consultation in Caracas, Venezuela, where a primary bilateral total hip arthroplasty procedure is performed in two stages (separated by a 5-month interval between each intervention) using a modified Hardinge lateral approach. At one year of follow-up, the patient shows good progress, high satisfaction levels, and symmetrical lower limbs. THA in young patients with severe, limiting, and painful osteoarthritis secondary to Perthes disease is a suitable option for returning to a low-impact professional life. Thanks to the design and materials of the new prostheses, the procedure can provide additional benefits for these patients. Long-term studies are necessary to determine the timing and causes of revisions in these complex cases.
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