Treatment of dysplastic and congenitally dislocated hips with the Zweymueller total hip prosthesis

Uncemented Zweymueller total hip prostheses were implanted in 35 dysplastic or dislocated hips in 33 patients. Sixteen hips were dislocated and 19 hip s were dysplastic; in 12 hips, an intertrochanteric or pelvic osteotomy was performed in early childhood. In all cases, the titanium screw socket was implanted at the level of the original cotyloid cavity. Osteotomy of the gr eater trochanter, shortening osteotomy, or roof acetabuloplasty were not pe rformed. In cases in which the femoral cavity was too narrow for the Zweymu eller stem, an anterolateral longitudinal window-shaped osteotomy was perfo rmed. In cases of severe dysplasia, cotyloid cavity bone grafts from the re sected femoral head were placed medially to reinforce the acetabular bottom . Clinical and radiographic follow-up ranged from 3-8 years. Average Harris hip score improved from 47 points preoperatively to 86.2 points postoperat ively. Complications included two primary anterior dislocations, two tempor ary femoral nerve pareses, and two deep vein thromboses. At longest follow- up evaluation, no revision was indicated in any of the hips. Satisfactory r esults in this series were attributed to careful patient selection, precise preoperative radiographic planning, and an operative technique that includ ed implantation of the socket at the primary acetabulum and achievement of primary stability using press-fit fixation.