The various surgical prosthetic solutions in coxarthrosis on a dysplastic basis were evaluated in a critical way.

In our institute more than 3,750 hip prostheses were implanted from 1994 to 1999, and 366 (9.76%) were used for dysplastic coxarthrosis. This high percentage can be explained by the particular geographical position of our institute that has patients coming from the Lombardia region area where CDH is endemic.

Our evaluations consider the highest number of possible parameters in order to realize which is the most modern and reliable surgical solution. Of course, each case is individual and our advantage is to have a prosthesis that is the most suitable for each patient.

The number and type of prostheses used were: 27 ABG, 35 CONUS, 25 CUSTOM MADE, 7 HN, 5 MALLORY, 35 OMNIFLEX, 3 PARHOFER PLASMAPORE, 4 PERSONALISED CUSTOM MADE, 3 RIPPEN, 18 RMHS, 45 SAMO PG, 130 ZWEYMULLER, 18 P507, 6 OMNIFIT, and 5 GYPSE.

From our unique perspective we can consider that in the last several years the use of a cemented prosthesis is progressively disappearing (less than 13%). The use of a cementless prosthesis in young patients (age range 20 to 65) preserves bone stock during implantation, placement and replacement when necessary. If the patient’s age and general conditions allow, we generally operate both dysplastic hips in one stage.

All cases were evaluated with DEXA, which provides qualitative and quantitative data about the periprosthetic bone stock. Various parameters were studied, including restoration of normal biomechanics, centre of rotation, equalisation of limb-length, the Trendelenburg sign, and nerve complications.