Total hip replacement in the congenitally dislocated hip using the Paavilainen technique

BACKGROUND AND PURPOSE Total hip replacement (THR) in congenitally dislocated hips (CDHs) according to Paavilainen includes placement of the cup in the original acetabulum and an extended trochanteric osteotomy with distal advancement of the trochanter. There have only been a few reports describing the outcome of this technique. Thus, we report the results of 19 THRs using the Paavilainen technique. METHODS 10 women and 5 men with an average age of 38 (16-73) years at the time of surgery (19 hips) were followed for mean 4.8 (1.5-10) years. The patients were evaluated clinically with the Harris hip score (HHS) and radiographically using the Gruen and Charnley classification. RESULTS All patients experienced substantial improvement in walking ability and relief of pain. Trendelenburg test was positive in 18 hips preoperatively, and only in 1 postoperatively. 1 case had transient incomplete peroneal palsy. There were 4 cases of intraoperative fissures of the proximal femur. No infections occurred, and no aseptic loosening was observed. 3 hips dislocated in the follow-up period; 2 were reduced open and 1 had a closed reduction. Due to wear of the polyethylene, 3 patients needed replacement of the liner. INTERPRETATION These intermediate to long-term results indicate that the Paavilainen technique provides a functional hip with a limited rate of complications. Wear of the polyethylene liner is, however, still an unresolved issue.