This study compared the results of total hip arthroplasty (THA) in 11 patients with 13 hips who underwent THA after a failed triple innominate osteotomy (TIO) with an age-matched and sex-matched group of patients who underwent THA without prior TIO. The average age at the time of THA was 37 years (range, 16-50 years). The average follow-up of the patients who underwent THA for failed TIO was 36 months and for the control group was 28 months. One hip in each group underwent revision for dislocation. At final follow-up, the average Harris hip score in the study group was 76, whereas in the control group it was 88 (P <.05). The pain component of the Harris hip score in the study group averaged 32, whereas in the control group it averaged 40 (P <.05). Functional scores between the 2 groups were similar. Radiographically, there was no difference between the 2 groups. Estimated blood loss for the hips performed for failed TIO averaged 721 mL, whereas in the control group the estimated blood loss averaged 448 mL (P <.05). There was no difference in operative time. The results of this study indicated that although the radiographic results of THA after TIO are equivalent to THA without prior TIO, clinical results in terms of pain relief and the technical difficulty of THA are not equivalent to results in young adult patients who undergo THA without prior TIO.