Reference lines and joint orientation angles after hip and knee arthroplasty should be within the normal range to avoid deformity and help ensure long-term use of the endoprosthesis (Robert et al., J Knee Surg 31(01):002- 005, 2018; Richard et al., Knee Surg Sports Traumatol Arthrosc 26:1506-1514, 2018; Rivière et al., Orthop Traumatol Surg Res 103(7):1047-1056, 2017; Sculco et al., J Am Acad Orthop Surg 27(18):p819-p830, 2019). It is not correct to install an endoprosthesis into a deformed bone if the maneuvers used for endoprosthetics do not eliminate the deformity. A patient with a two-apex deformity of the femur, who nevertheless underwent hip arthroplasty, is presented. For obvious reasons, arthroplasty did not improve the function of the lower limb. The knee arthroplasty of the same extremity indicated to the patient was also not feasible. In this regard, the patient underwent a double osteotomy of the femur for gradual bi-level deformity correction using an orthopedic hexapod Ortho-SUV Frame (OSF). The “spring technique” (Solomin et al., J Limb Lengthen Reconstr 4:83-89, 2018) was used, which made it possible to use one OSF set and one calculation in OSF-software for deformation correction simultaneously on two levels. The correction period was 87 days, and the fixation period was 383 days. Ten months after dismantling the frame, the right knee joint arthroplasty was performed. Good anatomical and functional results were obtained. © Springer Nature Switzerland AG 2015, 2024.