Arthroprosthesis in old unreduced congenital dislocation of the hip, using the 'false' acetabulum. A study of 34 cases

The authors review the alternative surgical solutions available in the treatment of unreduced congenital dislocation of the hip in adults with disabling secondary arthrosis. They describe their technique for applying a prosthesis based on using the false joint in the pathological position. The analysis of 34 results with an average follow-up of 5 years dispelled the legitimate doubts about the validity of this approach; 29 cases showed marked improvement, loosening of the femoral prosthesis occurred in only one case and there were very few radiological signs indicating a risk of loosening. The authors conclude by defining the indications for this operation, namely, elderly patients with fixed and therefore irreversible changes in the neighbouring joints, and elderly patients in whom any sacrifice of the peri-articular muscles would be likely to cause excessive instability of the prosthesis.