Acetabuloplasty for neglected dislocation of the hip in older children.

This paper describes the technique and results of an acetabuloplasty in which the false acetabulum is turned down to augment the dysplastic true acetabulum at its most defective part. This operation was performed in 17 hips (16 children), with congenital dislocation and false acetabula. The mean age at operation was 5.1 years (4 to 8). The patients were followed clinically and radiologically for a mean of 6.3 years (5 to 10). A total of 16 hips had excellent results and there was one fair result due to avascular necrosis. The centre-edge angles and the obliquity of the acetabular roof improved in all cases, from a mean of -15.9 degrees (-19 degrees to 3 degrees ) and 42.6 degrees (33 degrees to 46 degrees ) to a mean of 29.5 degrees (20 degrees to 34 degrees ) and 11.9 degrees (9 degrees to 19 degrees ), respectively. The technique is not complex and is stable without internal fixation. It provides a near-normal acetabulum that requires minimal remodelling, and allows early mobilisation.