Rationale and indications for the "hanging hip" procudure: a clinical and experimental study

A series of 71 patients treated by "hanging hip" procedures was followed for up to 12 years. The procedure provided a satisfactory result in patients even with severe hip joint degeneration as long as the congruity of the joint is preserved and there was no concentration of stress. When these conditions are not fulfilled the results are poor. An experimental study was carried out to try and ascertain the physiological rationale for the "healing" seen in patients with good preoperative indications. The articular cartilage of one hip in cats was denuded with a curette. This was accompanied in half the animals with a "hanging hip" procedure. The hips of the animals with "hanging hip" went onto fibrocartilaginous and chondroid healing of their articular surfaces and clinically did well. The hips of the animals who did not have multiple tenotomies developed osteoarthrosis. Full thickness cartilage defects in weight-bearing areas in adult animals are capable of functional healing if the mechanical stress on the joint is sufficiently decreased. The "hanging hip" operation should no longer be considered a salvage procedure. A physiological rationale exists for it in properly selected patients and represents a reasonable alternative to total hip replacement.