Although more and more young surgeons in the United States are beginning to use the lateral or anterolateral approach without osteotomy to perform this type of surgery, Dr. Kastenbaum has always advocated and used the lateral approach with the greater trochanter osteotomy to perform total hip arthroplasty. It should be said that after adopting the osteotomy of the greater trochanter, the field of operation is clearly revealed, which is easy to judge the normal position of the prosthesis and deal with the acetabulum and femur. After the operation, the greater trochanter adopts cable to do strong fixation, and since the gluteus medius muscle did not receive any interference or damage, the adductor strength of all patients was very good after the operation, and when they came to the follow-up examination in 6 weeks, their gait was already close to normal. The general steps of the operation: the patient took the supine position, the femur was cut up and down centering on the greater trochanter to reveal the greater trochanter, the greater trochanter was osteotomized and turned over to the top of the acetabulum, and the acetabulum was pulled away by automatic pulling hooks, so that the acetabulum was revealed very clearly. After treatment of the acetabulum, the acetabular prosthesis was installed, and then the femoral prosthesis was installed after contusion of the femoral marrow cavity. Fixation of the greater trochanter after repositioning. Lesson 1: When the acetabulum is processed, the acetabulum is abraded vertically with the acetabular recess as the center, and when it is smaller than the actual size of the acetabulum by about 4 sizes, the acetabulum is processed according to the physiological anterior tilt angle and external rotation angle. Experience 2: The special automatic pulling hook is used during the operation, which reveals the acetabulum very clearly, and the cable fixation of the greater trochanteric osteotomy is firm and reliable. The disadvantage is that it increases the burden of the patient, and some patients do not accept the Cable to stay in the body.