Acetabular Cup Positioning during Total Hip Replacement in Osteoarthritis Secondary to Developmental Dysplasia of the Hip - a Review of the Literature

Various surgical treatments for osteoarthritis (OA) secondary to hip dysplasia have been reported in the literature. According to the position of the arthroplasty cup, generally they could be divided into two groups: the primary rotational center (PRC) group and the high hip center (HHC) group. Some surgeons prefer the HHC technique. Without doubt it is less demanding, but several concerns exist against the long-term stability. When restoring the PRC, since the dysplastic acetabulum is usually shallower and underdeveloped, bone grafts or other biosynthetic materials are usually needed for the ideal fixation. The source of grafts is quite wide. For example, they could be autologous (femoral head, iliac crest) or homologous (allografts), bulky or morselized. Medial wall protrusion technique, as well as other materials like oblong cup, porous titanium and tantalum augments, 3D printed implants could also be an option. Except these, reports are also divided into cemented and cementless techniques. Therefore, no technique is perfect and clinical results so far are quite variable. We think it's necessary to compare the pros and cons between each other.