Treatment of osteoarthrosis secondary to congenital dislocation of the hip. Primary cemented surface replacement compared with conventional total hip replacement.

Seventy-four cemented conventional total hip arthroplasties (in fifty-five patients) and thirty-seven cemented surface replacements (in thirty-two patients) were done between 1971 and 1984 for treatment of osteoarthrosis secondary to congenital dislocation of the hip. The patients in the first group were older and had more severe dysplasia. In all patients, we tried to position the acetabular component at the level of the true acetabulum. In both groups, the operation relieved pain and improved the function of the hip in the short term. There were fewer and less severe early postoperative complications in the surface-replacement group, but the rate of long-term failure (revision or resection) was substantially higher. Survivorship analysis demonstrated that neither type of operation yielded durable results in younger patients; all revisions were in patients who were less than sixty years old. However, in older patients who had cemented conventional total hip arthroplasty, survivorship was excellent, regardless of the amount of dysplasia.