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Joann Lee - One of the best experts on this subject based on the ideXlab platform.
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arthroscopic intervention in early Hip Disease
Clinical Orthopaedics and Related Research, 2004Co-Authors: Joseph C Mccarthy, Joann LeeAbstract:Advancement in diagnostic and therapeutic applications for Hip arthroscopy have dispelled previous myths about early Hip Disease. Arthroscopic findings have established the following facts: Acetabular labral tears do occur; acetabular chondral lesions do exist; tears are most frequently anterior and often associated with sudden twisting or pivoting motions; and labral tears often occur in association with articular cartilage lesions of the adjacent acetabulum or femoral head, and if present for years, contribute to the progression of delamination process of the chondral cartilage. Magnetic resonance arthrography represents an improvement over conventional magnetic resonance imaging, it does have limitations when compared with direct observation. Although indications for Hip arthroscopy are constantly expanding, the most common indications include: labral tears, loose bodies, chondral flap lesions of the acetabular or femoral head, synovial chondromatosis, foreign body removal, and crystalline Hip arthropathy (gout, pseudogout, and others). Contraindications include conditions that limit the potential for Hip distraction such as joint ankylosis, dense heterotopic bone formation, considerable protrusio, or morbid obesity. Complication rates have been reported between 0.5 and 5%, most often related to distraction and include sciatic or femoral nerve palsy, avascular necrosis, and compartment syndrome. Transient peroneal or pudendal nerve effects and chondral scuffing have been associated with difficult or prolonged distraction. Meticulous consideration to patient positioning, distraction time and portal placement are essential. Judicious patient selection and diagnostic expertise are critical to successful outcomes. Candidates for Hip arthroscopy should include only those patients with mechanical symptoms (catching, locking, or buckling) that have failed to respond to conservative therapy. The extent of articular cartilage involvement has the most direct relationsHip to surgical outcomes. Improvements in technique and instrumentation have made Hip arthroscopy an efficacious way to diagnose and treat a variety of intra-articular problems.
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the role of labral lesions to development of early degenerative Hip Disease
Clinical Orthopaedics and Related Research, 2001Co-Authors: Joseph C Mccarthy, Philip C Noble, Michael Schuck, John Wright, Joann LeeAbstract:The current authors examined the hypothesis that labral lesions contribute to early degenerative Hip Disease. Between 1993 and 1999, 436 consecutive Hip arthroscopies were done by the senior author. In addition, 54 acetabula were harvested from human adult cadavers. Two hundred forty-one of the 436 (55.3%) patients who had arthroscopies had a 261 labral tears, all located at the articular, not capsular margin of the labrum. Stereomicroscopic examination of the 54 acetabula from cadavers revealed 52 labral lesions. Overall, there was no significant difference between the arthroscopic and cadaveric populations in terms of the incidence of labral tears. (Overall, 73% of patients with fraying or a tear of the labrum had chondral change. Arthroscopic and anatomic observations support the concept that labral disruption and degenerative joint Disease are frequently part of a continuum of joint Disease.
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the otto e aufranc award the role of labral lesions to development of early degenerative Hip Disease
Clinical Orthopaedics and Related Research, 2001Co-Authors: Joseph C Mccarthy, Philip C Noble, Michael Schuck, John A Wright, Joann LeeAbstract:The current authors examined the hypothesis that labral lesions contribute to early degenerative Hip Disease. Between 1993 and 1999, 436 consecutive Hip arthroscopies were done by the senior author. In addition, 54 acetabula were harvested from human adult cadavers. Two hundred forty-one of the 436 (55.3%) patients who had arthroscopies had a 261 labral tears, all located at the articular, not capsular margin of the labrum. Stereomicroscopic examination of the 54 acetabula from cadavers revealed 52 labral lesions. Overall, there was no significant difference between the arthroscopic and cadaveric populations in terms of the incidence of labral tears. (Overall, 73% of patients with fraying or a tear of the labrum had chondral change. Arthroscopic and anatomic observations support the concept that labral disruption and degenerative joint Disease are frequently part of a continuum of joint Disease.
Joseph C Mccarthy - One of the best experts on this subject based on the ideXlab platform.
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arthroscopic intervention in early Hip Disease
Clinical Orthopaedics and Related Research, 2004Co-Authors: Joseph C Mccarthy, Joann LeeAbstract:Advancement in diagnostic and therapeutic applications for Hip arthroscopy have dispelled previous myths about early Hip Disease. Arthroscopic findings have established the following facts: Acetabular labral tears do occur; acetabular chondral lesions do exist; tears are most frequently anterior and often associated with sudden twisting or pivoting motions; and labral tears often occur in association with articular cartilage lesions of the adjacent acetabulum or femoral head, and if present for years, contribute to the progression of delamination process of the chondral cartilage. Magnetic resonance arthrography represents an improvement over conventional magnetic resonance imaging, it does have limitations when compared with direct observation. Although indications for Hip arthroscopy are constantly expanding, the most common indications include: labral tears, loose bodies, chondral flap lesions of the acetabular or femoral head, synovial chondromatosis, foreign body removal, and crystalline Hip arthropathy (gout, pseudogout, and others). Contraindications include conditions that limit the potential for Hip distraction such as joint ankylosis, dense heterotopic bone formation, considerable protrusio, or morbid obesity. Complication rates have been reported between 0.5 and 5%, most often related to distraction and include sciatic or femoral nerve palsy, avascular necrosis, and compartment syndrome. Transient peroneal or pudendal nerve effects and chondral scuffing have been associated with difficult or prolonged distraction. Meticulous consideration to patient positioning, distraction time and portal placement are essential. Judicious patient selection and diagnostic expertise are critical to successful outcomes. Candidates for Hip arthroscopy should include only those patients with mechanical symptoms (catching, locking, or buckling) that have failed to respond to conservative therapy. The extent of articular cartilage involvement has the most direct relationsHip to surgical outcomes. Improvements in technique and instrumentation have made Hip arthroscopy an efficacious way to diagnose and treat a variety of intra-articular problems.
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the role of labral lesions to development of early degenerative Hip Disease
Clinical Orthopaedics and Related Research, 2001Co-Authors: Joseph C Mccarthy, Philip C Noble, Michael Schuck, John Wright, Joann LeeAbstract:The current authors examined the hypothesis that labral lesions contribute to early degenerative Hip Disease. Between 1993 and 1999, 436 consecutive Hip arthroscopies were done by the senior author. In addition, 54 acetabula were harvested from human adult cadavers. Two hundred forty-one of the 436 (55.3%) patients who had arthroscopies had a 261 labral tears, all located at the articular, not capsular margin of the labrum. Stereomicroscopic examination of the 54 acetabula from cadavers revealed 52 labral lesions. Overall, there was no significant difference between the arthroscopic and cadaveric populations in terms of the incidence of labral tears. (Overall, 73% of patients with fraying or a tear of the labrum had chondral change. Arthroscopic and anatomic observations support the concept that labral disruption and degenerative joint Disease are frequently part of a continuum of joint Disease.
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the otto e aufranc award the role of labral lesions to development of early degenerative Hip Disease
Clinical Orthopaedics and Related Research, 2001Co-Authors: Joseph C Mccarthy, Philip C Noble, Michael Schuck, John A Wright, Joann LeeAbstract:The current authors examined the hypothesis that labral lesions contribute to early degenerative Hip Disease. Between 1993 and 1999, 436 consecutive Hip arthroscopies were done by the senior author. In addition, 54 acetabula were harvested from human adult cadavers. Two hundred forty-one of the 436 (55.3%) patients who had arthroscopies had a 261 labral tears, all located at the articular, not capsular margin of the labrum. Stereomicroscopic examination of the 54 acetabula from cadavers revealed 52 labral lesions. Overall, there was no significant difference between the arthroscopic and cadaveric populations in terms of the incidence of labral tears. (Overall, 73% of patients with fraying or a tear of the labrum had chondral change. Arthroscopic and anatomic observations support the concept that labral disruption and degenerative joint Disease are frequently part of a continuum of joint Disease.
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the role of Hip arthroscopy in the diagnosis and treatment of Hip Disease
Orthopedics, 1995Co-Authors: Joseph C Mccarthy, Brian D BusconiAbstract:Injuries to the Hip are commonly encountered by orthopedic surgeons and will, for the most part, respond well to conservative therapy. When a patient's Hip pain has not responded to the appropriate treatment and radiographic measurements have not shown any specific pathology, arthroscopy of the Hip can be a valuable diagnostic and therapeutic procedure. We retrospectively reviewed 94 consecutive patients who experienced refractory Hip pain that persisted longer than 6 months (average: 2.1 years) and who had an average follow up of 2.5 years. Statistical analysis was performed using Fisher's Exact Test (P value) and Pearson (r value) correlation coefficient to compare preoperative symptomatology and physical examination findings with intraoperative pathology. Statistically significant results were obtained when comparing preoperative symptoms of a painful Hip click and mechanical symptoms of locking with acetabular labral injuries (P = .000, r = .896) and loose bodies (P = .000, r = .896), respectively. Radiologic studies were nondiagnostic in 76% of patients in this series. Hip arthroscopy can be a valuable and viable procedure in the diagnosis and treatment of protracted or progressive Hip pain lasting more than 6 months.
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the role of Hip arthroscopy in the diagnosis and treatment of Hip Disease
Canadian Journal of Surgery, 1995Co-Authors: Joseph C Mccarthy, Brian D BusconiAbstract:OBJECTIVE To report the results of arthroscopy performed on adults with Hip Disease who did not respond to extended conservative treatment and to evaluate the relationsHip between clinical findings, radiologic tests and surgical abnormalities. DESIGN A case study. SETTING New England Baptist Hospital, Boston, Mass. PATIENTS Fifty-nine patients (32 women, 27 men) with refractory Hip pain, between the ages of 17 and 69 years, who were seen between January 1989 and January 1992. INTERVENTION Hip arthroscopy. MAIN OUTCOME MEASURES Cause of Hip pain, results of physical examination and operative findings. RESULTS In 26 patients the cause of Hip pain was traumatic; in 21 the cause was idiopathic. On physical had pain on straight leg examination, 56% of patients reported painful clicking of the Hip joint, 37% had pain on straight leg raising, 9% had decreased extension and 34% had had episodes of locking of the joint. Five percent had pain predominantly in the thigh, 41% reported at least one episode of "giving way" of the Hip and 7% had snapping of the iliotibial band. At arthroscopy, 69% of patients had synovitis in the Hip joint, 59% had a tear of the acetabular labrum, 39% had loose bodies, 32% had degenerative arthritis and 27% had a chondral defect. On statistical analysis, significant (p < 0.05) relationsHips were found between acetabular labral tears and preoperative complaints of clicking or giving way, between loose bodies and preoperative locking and between degeneration of the Hip joint and thigh pain. CONCLUSION Arthroscopy of the Hip is a valuable diagnostic and therapeutic procedure for patients with Hip pain refractory to conservative therapy.
Nobuhiko Sugano - One of the best experts on this subject based on the ideXlab platform.
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change in pelvic sagittal inclination from supine to standing position before Hip arthroplasty
Journal of Arthroplasty, 2017Co-Authors: Keisuke Uemura, Masaki Takao, Takashi Sakai, Yoshito Otake, Koki Koyama, Futoshi Yokota, Hidetoshi Hamada, Yoshinobu Sato, Nobuhiko SuganoAbstract:Abstract Background Cup anteversion and inclination are important for avoiding implant impingement and dislocation in total Hip arthroplasty. However, functional cup anteversion and cup inclination also change as the pelvic sagittal inclination (PSI) changes. Therefore, PSI in both supine and standing positions was measured in a large cohort in this study. Methods A total of 422 patients (median age, 61; range, 15-87) who underwent total Hip arthroplasty were the subjects of this study. There were 83 patients with primary osteoarthritis (OA), 274 patients with developmental dysplasia–derived secondary OA, 48 patients with osteonecrosis, and 17 patients with rapidly destructive coxopathy (RDC). Preoperative PSI in supine and standing positions was measured by automated computed topography segmentation and landmark localization of the pelvis followed by intensity-based 2D-3D registration, and the number of cases in which PSI changed more than 10° posteriorly was calculated. Hip Disease, sex, and age were analyzed if they were related to a PSI change of more than 10°. Results The median PSI was 5.1° (interquartile range, 0.4°-9.4°) in supine and −1.3° (interquartile range, −6.5° to 4.2°) in standing position. There were 79 cases (19%) in which the PSI changed more than 10° posteriorly from supine to standing. Elder age and patients with primary OA and RDC were revealed to be the related factors. Conclusion PSI changed more than 10° posteriorly from supine to standing in 19% of cases. Age and diagnosis of primary OA and RDC were the significant factors for the posterior rotation.
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change in pelvic sagittal inclination from supine to standing position before Hip arthroplasty
Journal of Bone and Joint Surgery-british Volume, 2017Co-Authors: Keisuke Uemura, Masaki Takao, Takashi Sakai, Yoshito Otake, Koki Koyama, Futoshi Yokota, Hidetoshi Hamada, Yoshinobu Sato, Nobuhiko SuganoAbstract:Background Cup anteversion and inclination are important to avoid implant impingement and dislocation in total Hip arthroplasty (THA). However, it is well known that functional cup anteversion and cup inclination also change as the pelvic sagittal inclination (PSI) changes, and many reports have been made to investigate the PSI in supine and standing positions. However, the maximum numbers of subjects studied are around 150 due to the requirement of considerable manual input in measuring the PSIs. Therefore, PSI in supine and standing positions were measured fully automatically with a computational method in a large cohort, and the factors which relate to the PSI change from supine to standing were analyzed in this study. Methods A total of 422 patients who underwent THA from 2011 to 2015 were the subjects of this study. There were 83 patients with primary OA, 274 patients with DDH derived secondary OA (DDH-OA), 48 patients with osteonecrosis, and 17 patients with rapidly destructive coxopathy (RDC). The median age of the patient was 61 (range; 15–87). Preoperative PSI in supine and standing positions were measured and the number of cases in which PSI changed more than 10° posteriorly were calculated. PSI in supine was measured as the angle between the anterior pelvic plane (APP) and the horizontal line of the body on the sagittal plane of APP, and PSI in standing was measured as the angle between the APP and the line perpendicular to the horizontal surface on the sagittal plane of APP (Fig. 1). The value was set positive if the pelvis was tilted anteriorly and was set negative if the pelvis tilted posteriorly. Type of Hip Disease, sex, and age were analyzed with multiple logistic regression analysis if they were related to PSI change of more than 10°. For accuracy verification, PSI in supine and standing were measured manually with the previous manual method in 100 cases and were compared with the automated system used in this study. Results The median PSI in the supine position was 5.1° (interquartile range [IQR]: 0.4 to 9.4°), and the median PSI in the standing position was −1.3° (IQR: −6.5 to 4.2°). There were 79 cases (19%) in which the PSI changed more than 10° posteriorly from supine to standing with a maximum change of 36.9° (Fig. 2). In the analysis of the factors, type of Hip Disease (p = 0.015) and age (p = 0.006, Odds Ratio [OR] = 1.035) were the significant factors. The OR of primary OA (p = 0.005, OR: 2.365) and RDC (p = 0.03, OR: 3.146) were significantly higher than DDH-OA. In accuracy verification, the automated PSI measurement showed ICC of 0.992 (95% CI: 0.988 to 0.955) for supine measurement and 0.978 (95% CI: 0.952 to 0.988) for standing measurement. Conclusions PSI changed more than 10° posteriorly from supine to standing in 19% of the cases. Age and diagnosis of primary OA and RDC were related to having their pelvis recline more than 10° posteriorly. For any figures or tables, please contact authors directly (see Info & Metrics tab above).
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synovial joint fluid cytokine levels in Hip Disease
Rheumatology, 2014Co-Authors: Takashi Sakai, Wataru Ando, Nobuo Nakamura, Toshimitsu Hamasaki, Masaki Takao, Takashi Nishii, Hideki Yoshikawa, Nobuhiko SuganoAbstract:Objective. The purpose of this study was to evaluate cytokine level characteristics in the Hip joint fluid, including rapidly destructive coxopathy (RDC), OA, osteonecrosis (ON) of the femoral head and RA. Methods. Thirty-three Hips with RDC, 57 with OA, 36 with ON and 10 with RA were included in the study. OA Hips were divided into two groups: 20 Hips with early OA without joint space narrowing and 37 Hips with terminal OA. ON Hips were divided into three groups: 13 Hips with 3 mm collapse and 9 Hips with terminal ON. Joint fluid was collected during surgery. Cytokine levels including IL-1b, IL-6, IL-8 and TNF-a were measured using homogeneous time-resolved fluorescence. Results. All measured cytokine levels in RDC were significantly higher than those in OA (P 3 mm collapse were higher than those found in the ON group with <3 mm collapse. In comparing cytokine levels between RDC, terminal OA, RA and terminal ON, RDC showed significantly higher IL-8 levels than terminal OA and RA (P < 0.05). Conclusion. IL-8 levels in RDC were higher than in the other Hip Diseases. The IL-8 level may reflect the aggressiveness of joint destruction in RDC, and IL-6 and TNF-a levels may also reflect ongoing destruction in OA and ON.
Naoki Ishiguro - One of the best experts on this subject based on the ideXlab platform.
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do femoral head collapse and the contralateral condition affect patient reported quality of life and referral pain in patients with osteonecrosis of the femoral head
International Orthopaedics, 2018Co-Authors: Yusuke Osawa, Yasuhiko Takegami, Taisuke Seki, Takehiro Kasai, Yoshitoshi Higuchi, Naoki IshiguroAbstract:The objectives of this study were to investigate patient-reported outcomes and referral pain at the first visit in patients with osteonecrosis of the femoral head (ONFH) and to clarify the influence of collapse of the femoral head and the contralateral condition. The study included 105 patients (130 Hips) with ONFH at the first visit, who were divided into two groups based on the presence of bilateral walking Hip pain (bilateral group 25 patients, 50 Hips) and unilateral Hip pain (unilateral group 80 patients, 80 Hips). We compared the Short Form-36 (SF-36), Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ), and visual analog scale (VAS) responses for Hip, knee, and low back pain between the groups to investigate the influence of the contralateral condition. Regarding the influence of femoral head collapse, we investigated these subjects based on the stage classification in the unilateral group. The physical component summary (PCS) of the SF-36 and all domains of the JHEQ were poorer in the bilateral group than in the unilateral group. In addition, the VAS score for low back pain was significantly poorer in the bilateral group than in the unilateral group. Regarding the collapse of the femoral head, the SF-36 for the PCS and JHEQ for pain had a significant relationsHip in the ONFH stage. The VAS scores for Hip and knee pain had a significant relationsHip in the ONFH stage. Collapse of the femoral head and the contralateral condition of ONFH strongly affect patients’ activities of daily life.
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total Hip arthroplasty after transtrochanteric rotational osteotomy for osteonecrosis of the femoral head a mean 10 year follow up
Journal of Arthroplasty, 2017Co-Authors: Yusuke Osawa, Daigo Morita, Toshiaki Okura, Yasuhiko Takegami, Taisuke Seki, Naoki IshiguroAbstract:Abstract Background The objective of the present study was to investigate clinical, quality of life, and radiographic outcomes of patients who underwent total Hip arthroplasty (THA) after transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head (ONFH). Methods We performed a case-control study. The participants were 29 patients (34 Hips) who underwent THA after TRO (TRO group). These patients had a mean age at surgery of 51.6 years (range, 30-72 years) and underwent postoperative follow-up for a mean period of 10.5 years (range, 3-19 years). For the control group (primary group), we included 58 patients (68 Hips) who underwent primary THA for ONFH, matching for age and gender. Results The Harris Hip Scores at the last follow-up were significantly poorer in the TRO group than in the primary group. Similarly, preoperative and postoperative Hip range of motion was significantly poorer in the TRO group than in the primary group. Quality of life (Short Form-36, Oxford Hip Score, and Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire) and complication rates were not significantly different between the groups. The survival rates at 10 years, with revision for any reason as the endpoint, were 81% in the TRO group and 91% in the primary group, showing no significant difference between the groups. The TRO group had a larger average postoperative leg length discrepancy and a higher rate of stem malalignment than the primary group. Conclusion The clinical outcomes of THA after TRO for ONFH were poorer than those of primary THA.
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reliability and validity of the japanese orthopaedic association Hip Disease evaluation questionnaire jheq for patients with Hip Disease
Journal of Orthopaedic Science, 2013Co-Authors: Taisuke Seki, Naoki Ishiguro, Yukiharu Hasegawa, Kazuma Ikeuchi, Yoshimitsu HiejimaAbstract:Background The Japanese Orthopaedic Association Hip Disease evaluation questionnaire (JHEQ) was developed to evaluate the quality of life (QOL) in patients with Hip Disease. This questionnaire consists of three subscales: pain; movement; and mental. The purpose of this study was to assess the reliability and validity of the JHEQ for use as a clinical evaluation tool.
Theofilos Karachalios - One of the best experts on this subject based on the ideXlab platform.
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congenital Hip Disease in adults
2013Co-Authors: Theofilos Karachalios, George HartofilakidisAbstract:This paper reviews the current knowledge relating to the management of adult patients with congenital Hip Disease. Orthopaedic surgeons who treat these patients with a total Hip replacement should be familiar with the arguments concerning its terminology, be able to recognise the different anatomical abnormalities and to undertake thorough pre-operative planning in order to replace the Hip using an appropriate surgical technique and the correct implants and be able to anticipate the clinical outcome and the complications.
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total Hip arthroplasty for congenital Hip Disease
Journal of Bone and Joint Surgery American Volume, 2004Co-Authors: George Hartofilakidis, Theofilos KarachaliosAbstract:Background: It is generally agreed that the clinical and radiographic results of total Hip replacement performed for degenerative arthritis secondary to congenital Hip Disease vary depending on the severity of the anatomical abnormality. In this study, we report the mid-term and long-term clinical and radiographic results of total Hip arthroplasty performed for each of the three different types of congenital Hip Disease. Methods: Between 1976 and 1994, the senior author performed 229 consecutive primary total Hip arthroplasties in 168 patients with osteoarthritis secondary to congenital Hip Disease. Seventy-six Hips were dysplastic, sixty-nine had a low dislocation, and eighty-four had a high dislocation. The Charnley low-friction technique was performed in 178 Hips, and the so-called hybrid technique was performed in forty-six Hips. Cementless arthroplasty was used in only five Hips. Results: After a minimum of seven years of follow-up, the rates of revision of the acetabular components were 15% in the dysplastic Hips, 21% in the Hips with a low dislocation, and 14% in those with a high dislocation. The rates of revision of the femoral components were 14%, 14%, and 16%, respectively. SurvivorsHip analysis predicted an overall rate of prosthetic survival at fifteen years of 88.8% ± 4.8% in the dysplastic Hips, 73.9% ± 7.2% in the Hips with a low dislocation, and 76.4% ± 8.1% in those with a high dislocation. Conclusions: An understanding of the anatomical abnormalities and the use of appropriate techniques and implants make total Hip arthroplasty feasible for treatment of the three types of congenital Hip Disease. In patients with a low dislocation, the major technical problem is reconstruction of the natural acetabulum. In those with a high dislocation, the challenge is to place the acetabular component inside the reconstructed true acetabulum and to use an appropriate femoral implant in the hypoplastic narrow femoral diaphysis. Level of Evidence: Prognostic study, Level II-1 (retrospective study). See Instructions to Authors for a complete description of levels of evidence.
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congenital Hip Disease in adults classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total Hip arthroplasty
Journal of Bone and Joint Surgery American Volume, 1996Co-Authors: George Hartofilakidis, Theofilos Karachalios, Konstantinos Stamos, Theologos T Ioannidis, Nikolaos ZacharakisAbstract:We describe three distinct types of congenital Hip Disease in adults. The first type is dysplasia, in which the femoral head is contained within the original true acetabulum. The second type is low dislocation, in which the femoral head articulates with a false acetabulum, the inferior lip of which contacts or overlaps the superior lip of the true acetabulum, giving the appearance of two overlapping acetabula. The third type is high dislocation, in which the femoral head has migrated superoposteriorly and there is no contact between the true and the false acetabulum. We describe and classify the acetabular abnormalities and deficiencies found with these three types. If the anterior, posterior, and superior aspects of the acetabular component cannot be covered during a total Hip arthroplasty because of a deficient acetabulum in an adult who has congenital Hip Disease, we advocate an acetabuloplasty technique (which we have named a cotyloplasty) that involves medial advancement of the acetabular floor by the creation of a controlled comminuted fracture of its medial wall, autogenous bone-grafting, and the implantation of a small acetabular component with cement. This procedure was performed in sixty-six patients (eighty-six Hips). Forty-nine of the Hips had a high dislocation, thirty-one had a low dislocation, and six were dysplastic. Two to fifteen years (mean, seven years) after the operation, the clinical and radiographic results were satisfactory. Only two acetabular components needed to be revised for aseptic loosening, at 5.3 and 7.5 years postoperatively. Moreover, the cumulative success rate for the acetabular components was 100 per cent at five years and 93.2 per cent at ten years.