Seventy-four cemented conventional total hip arthroplasties (in
fifty-five patients) and thirty-seven cemented surface replacements (in
thirty-two patients) were done between 1971 and 1984 for treatment of
osteoarthrosis secondary to congenital dislocation of the hip. The patients
in the first group were older and had more severe dysplasia. In all
patients, we tried to position the acetabular component at the level of the
true acetabulum. In both groups, the operation relieved pain and improved
the function of the hip in the short term. There were fewer and less severe
early postoperative complications in the surface-replacement group, but the
rate of long-term failure (revision or resection) was substantially higher.
Survivorship analysis demonstrated that neither type of operation yielded
durable results in younger patients; all revisions were in patients who
were less than sixty years old. However, in older patients who had cemented
conventional total hip arthroplasty, survivorship was excellent, regardless
of the amount of dysplasia.