Psoas transfer for the treatment of congenital dislocation of the hip

Since 1965, anterolateral transfer of the psoas muscle has been employed by us as a routine surgical treatment for congenital dislocation of the hip joint. The transfer was carried out in association with open reduction in those patients in whom an intracapsular obstruction was evident, but corrective measures for acetabular dysplasia or cervicocapital deformity of the femur were not performed in this series. We treated 87 hip joints with this procedure from 1965 to 1973. In 38 hip joints, both open reduction and the psoas transfer were followed up for an average of 8 years. Thirteen hip joints with open reduction alone were included as controls. Position of the femoral head and development of the acetabulum and proximal end of the femur were assessed on X-rays, mainly after Severin's criteria. Redislocation was not encountered. Fifty percent of the hip joints with open reduction and the psoas transfer were classed as grade I or II. This figure is higher than that of controls, to which 23% were classed as grade I or II. Better concentricity of the head was achieved as determined by the CE angle (Wiberg). Development of acetabulum occurred when the transfer had been carried out in children under 1 year of age and was less likely in the older children. The detorsional effect of the psoas transfer remained questionable since detorsion in the transferred group did not exceed that of the controls.