Rotational acetabular osteotomy for the severely dysplastic hip in the adolescent and adult.

Rotational acetabular osteotomy performed since 1968 is a circumacetabular osteotomy of the acetabulum for the dysplastic hip. The preoperative center-edge angle of Wiberg of 95 hips (89 patients) was -15 degrees or less. Forty-one hips (39 patients) form the basis of this report. They were followed from four years to 16 years and seven months (average, seven years and nine months). Twenty-one hips were classified as the Severin Group IV (subluxation) and 20 hips as the Severin Group V (a secondary acetabulum). A detailed assessment using a number of roentgenographic indices confirmed that the majority of the severely dysplastic hips could be corrected to nearly normal anatomy. The postoperative clinical results were assessed by the modified clinical classification of Severin proposed by Gibson and Benson. This procedure may be indicated for the severely dysplastic hip with subluxation or a secondary acetabulum in the adolescent and adult.