TREATMENT OF RESIDUAL DYSPLASIA AFTER DEVELOPMENTAL DYSPLASIA OF THE HIP AS A PREVENTION OF EARLY COXARTHROSIS

Residual dysplasia is one of the sequelae of developmental dysplasia of the hip (DDH) when treatment is started too late or centering of the femoral head is not sufficient and immobilization not rigid enough. Slight dysplasias in stable joints may improve spontaneously. To prevent early coxarthrosis, more severe dysplastic and unstable joints in children should be treated by acetabular operations, not varus osteotomies. The author prefers acetabuloplasty with lateral turning of the acetabular roof. The joint is immediately stabilized by establishing a deeper cavity. Follow-up after growth has ceased shows good results after acetabuloplasty, but femoral neck and head deformities after varus osteotomies. To prevent early coxarthrosis in dysplastic joints of adolescents, rotation of the entire acetabulum ventrally and laterally by triple pelvic osteotomy close to the hip joint appears to be the best way to normalize dysplastic joints with long-standing effect.