Natural history of unreduced congenital dislocation of the hip in adults.

The natural history of 33 patients with 43 unreduced congenital dislocations of the hip was reviewed. The average age at the first consultation was 50 years. Four were men and 29 were women. Ten patients had bilateral and 23 unilateral complete dislocation. Average follow-up lasted 9.2 years. At the final follow-up 23 hips and 18 knees were painful. Lumbago was observed in 6 of 15 patients under the age of 50 and in 14 of 18 patients over the age of 50 at the final follow-up. The average Harris hip scores at the first and final consultations were 69 and 70, respectively. The average dislocation index was increased in the standing more than in the lying position. In unilaterally dislocated hips the average femorotibial angles in the ipsilateral and contralateral knees to the dislocated hip were 172 and 179 deg, respectively. Lumbar degenerative scoliosis of more than 5 deg was observed in 16 patients.