Total hip replacement in congenital dislocation of the hip.

Twenty cases of congenital dislocation of the hip were treated with total hip replacement. The hips were completely dislocated with the femoral head supported by a nearthrosis proximal to the original acetabulum. The concept was to reconstruct the hip with an acetabular cup at the site of the original acetabulum even if a portion of the proximal end of the femur had to be sacrificed in the process. The Harris prosthesis appears, in most instances, to be the most suitable type of prosthesis but it was concluded that the surgeon needs a selection or prostheses for this procedure. Nine-tenths of the patients were improved by the procedure and the complications could mostly be successfully dealt with. This type of surgery is justified in cases with special indications.