We describe the first case of a 62-year-old female symptomatic patient with multiple comorbidities presenting with coronal limb malalignment due to scoliosis and osteoarthritis who underwent a combined total hip arthroplasty and biplane opening wedge osteotomy of the distal femur in one procedure. It is essential to realize that in patients who present with multiple comorbidities, combining different established procedures should be considered as a therapeutic option. We detail the operative procedure, preoperative considerations, and postoperative rehabilitation. By reviewing the literature on operative techniques, we highlight how our findings can be applied to similar cases with multiple comorbidities. Our report underscores the importance of considering combined procedures as a viable therapeutic option for patients with complex medical histories.