Avascular necrosis in congenital hip dysplasia: the effect of treatment.

Fifty-one patients known to have developed avascular necrosis during treatment for congenital hip dislocations were studied. Thirty-nine patients were followed for a mean of 23 years, 7 months. They were classified as to the severity of involvement, the subsequent treatment provided, and their final result. The greater the involvement, the worse the outcome. Residual subluxation of hips resulted in a poor prognosis. Intervention with open reduction did not result in success. Varus femoral osteotomies and acetabuloplasties met with limited success. Total hip replacements have not resulted in long-term success.