Aim: Developmental hip dysplasia is a common disease and if not treated, it may cause secondary hip osteoarthrosis, and this may ultimately lead to total hip replacement in adulthood.Hence, multiple childhood osteotomies have been developed over time to prevent such incidence.The purpose of this study is to determine whether an osteotomy around the hip can delay the total hip replacement surgery and as a second objective evaluate the degree of technical difficulty involved in an arthroplasty, with and without previous osteotomy, in patients with developmental hip dysplasia. Materials and Methods:This retrospective cohort study involved patients with a history of dysplasia and total hip replacement done between February 2007 and January 2017, comparing patients who underwent osteotomies around the hip (n = 54) and those who did not (n = 135).However, patients diagnosed with Crowe III/IV requiring subtrochanteric ostectomy at the time of the replacement were excluded.The technical difficulty of the procedure was evaluated considering the surgical time and intraoperative bleeding as outcomes.Results: Overall, 189 hip arthroplasties were analyzed in 173 patients with a history of developmental hip dysplasia, of which 54 had osteotomy around the hip.The average age at which the arthroplasty was performed in patients without previous osteotomy was 55.1 years (p < 0.001) compared to patients with previous osteotomy that was 42.2 years (p < 0.001).The surgical time and intraoperative bleeding were higher in the group of patients with previous osteotomy and it was possible to demonstrate that this medical history increased the risk of having a prolonged surgical time (5.46 times; p < 0.001) and an increased risk of higher intraoperative bleeding (6.08 times; p < 0.001). Conclusion:Patients with osteotomies around the hip required hip arthroplasty surgery earlier and having a previous osteotomy made the overall procedure longer in surgical time and increased intraoperative bleeding.