Congenital hip dislocation and subtrochanteric pseudoarthrosis. Hip replacement based on computer-aided analysis.

A 57-year-old woman with neglected high congenital dislocation of the right hip (Figure 1) and a severe dysplasia of the left hip had progressive pain in both hips, leg-length discrepancy and limitation of motion. On the right side there was a subtrochanteric pseudoarthrosis after an osteotomy performed when the patient was 10 years of age. The patient was admitted to our department and the physical examination revealed a healthy woman, 75 kg, 167 cm tall. On the d'Aubign6 and Postel scale (1954), pain was 3, range of motion 2 (60") and walking capacity 3. Radiographs of the lumbar spine disclosed degenerative changes and hyperlordosis secondary to an anterior pelvic tilt. The right leg was 4 cm longer than the left (scanography). A CT scan of the right hip and proximal right femur was obtained using a Philips Tomoscan Lx wholebody scanner (2.9 sec. scanning time, OD angle of the