title: The hip-shelf procedure. A long-term evaluation.
abstract: Renewed interest in the hip-shelf procedure as a solution to the dysplastic acetabulum in the older child stimulated an evaluation of the long-term results in an effort to clarify the role of this procedure. Only patients with a minimum of ten years of follow-up were evaluated in the study. The average follow-up for the entire series of twenty-nine hips in twenty-seven patients was twenty-two years and ten months. At evaluation, pain was present in fifteen hips, a limp was present in twenty-five, and degenerative changes were present in twenty hips. Complications occurred in twenty-one hips and additional operative procedures were required in fourteen hips. Twenty-one of the twenty-nine hips were evaluated by us, with an average follow-up of twenty-five years and eight months. One hip was rated as excellent; eight, as satisfactory; and twelve, as poor. Although the hip-shelf procedure has been described as a safe, conservative, and reliable approach to the problem of a dysplastic acetabulum, our long-term results suggest a more cautious view of the use of this procedure. We recommend consideration of other stabilizing procedures for the dysplastic acetabulum.
mesh_terms: D000077:Acetabulum / Q000601:surgery; D001848:Bone Diseases, Developmental / Q000601:surgery; D002648:Child; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005684:Gait; D006618:Hip Dislocation, Congenital / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008722:Methods; D011183:Postoperative Complications; D012008:Recurrence