title: Acetabuloplasty at the anatomic centre for treating Crowe class III and IV developmental hip dysplasia: a case series.
abstract: BACKGROUND
  Total hip replacement in patients with developmental dysplasia of the hip (DDH) is a difficult technical procedure for surgeons to perform because of the potential for these patients to have severe anomalies in their bones and soft tissues.
  
  
  METHODS
  We performed acetabuloplasty in 54 hips from 44 patients by reaming the posterior wall of the native acetabulum and medialising the acetabular component to restore the anatomic centre of hip rotation using a small cup without bone grafting. Median time to post-surgery follow-up was 5 (range 2-14) years.
  
  
  RESULTS
  Prosthetic survival rates in patients after 2 and 5 years post hip replacement were 93% (50/54) and 89% (48/54), respectively. 4 patients required early revision because of malposition and instability of the acetabular cup. 3 patients with Crowe type IV dislocations had transient sciatic nerve palsy and 3 had deep vein thrombosis.
  
  
  CONCLUSIONS
  Placement of the acetabular shell using posterior bone stock to provide normal hip rotation is a successful alternative technique for acetabuloplasty in patients with DDH.
authors.affiliation: Capa Medical Faculty, Istanbul University, Istanbul - Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Sen
authors.affiliation: Orthopaedic and Traumatology Department, Bezmialem Vakif University, Istanbul - Turkey.
authors.forename: Kerem
authors.initials: K
authors.lastname: Bilsel
authors.affiliation: Orthopaedic and Traumatology Department, Bezmialem Vakif University, Istanbul - Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Elmadag
authors.affiliation: Orthopaedic and Traumatology Department, Gaziosmanpasa University, Istanbul - Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Gunes
authors.affiliation: Fatih Sultan Mehmet Educational Research Hospital, Istanbul - Turkey.
authors.forename: Baransel
authors.initials: B
authors.lastname: Saygi
mesh_terms: D065526:Acetabuloplasty / Q000379:methods*; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D006617:Hip Dislocation / Q000209:etiology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome