A Sharrard posterior iliopsoas muscle-transfer procedure was done in
forty-two hips of twenty-four children with myelodysplasia. Folow-up ranged
from twenty-nine months to approximately ten years. An over-all success
rate of 50 per cent was achieved which included all hips operated on for
potential and existing instability. The success rate for surgery in hips
with an existing instability was 29.6 per cent. Factors predisposing to a
poor result were: age more than five years old, dysplastic acetabulum
(index more than 30 degrees), prior hip surgery, and inequality of limb
length. This operation is recommended primarily for hips not previously
operated on in children less than five years old who have a normal
acetabular index. If the child is more than five years old or if acetabular
dysplasia exists, reconstruction of the acetabulum should precede or
accompany the tendon transfer for best results. Iliopsoas muscle transfer
is unlikely to be successful if used as a salvage procedure.