Acetabuloplasty in the treatment of congenital dislocation of the hip.

The results in 102 acetabuloplasties have been assessed in eighty-six patients, with a minimum follow-up of five years. Clinical and radiological assessment was carried out according to a score system very similar to that used in previous studies, and the results were expressed as excellent, good, fair and poor according to the score obtained. Any hip requiring further stabilising procedures was automatically grouped as a failure. Subtrochanteric femoral ostestomy was used when femoral anteversion was excessive. The results revealed that 73 per cent of the hips were satifactory (excellent or good) overall, but that a steady deterioration was evident when the five- and fifteen-year groups were compared. Few of the hips were regarded as normal on radiological grounds. Homologous bone bank rib was found to be the most satisfactory graft material. Coxa magna was the most common abnormality that was consistent with a good or excellent result. Avascular necrosis of the femoral head was found in only six hips; it was more commonly present in patients subjected to previous operation. Concentric reduction of the femoral head is essential if acetabuloplasty is to maintain stability of the hip.