Osteotomy as an alternative to total hip replacement in young adults

The young (under 50) patient with symptomatic osteoarthrosis of the hip from congenital hip dysplasia presents a difficult therapeutic problem. Although total hip replacement can be successful in such cases, the uncertaintly of a long-term result makes an alternative treatment attractive. A series of 15 patients with 17 involved hips were subjected to a carefully planned and executed valgus osteotomy combined with a selective muscle lengthening about the hip. Five years or more after this procedure 14 of the 17 hips of these patients were pain free. The other three hips caused mild pain only after exertion. No patient at final follow-up required external support. Sixteen of the 17 hips showed significant radiological regression of the osteoarthrosis.