To evaluate large/Jumbo acetabular cups in revision surgery, 52 cups in 48 patients were reviewed; mean age was 71. 6 years and mean follow up 6 years.

Average Harris Hip Score was 85. Excellent bony incorporation was seen in all but the failures, of which there were three, 1 due to infection and 2 due to aseptic loosening. Major complications included 2 intraoperative fractures.

Intermediate results of acetabular revisions, using large cups, without bone grafting are encouraging.

Aim: to evaluate the use of large acetabular cup in revision surgery without structural bone graft.

Materials/methods: Patients who had revision hip surgery at Greenwich Hospital between 1991 and 1994 were reviewed. All patients had complete clinical and radiological follow up.

Large cup was the press fit Mathys Isoelastic cup.

No patient had any structural bone grafting.

Failure was defined as need for surgery and/or poor clinical outcome.

Objective clinical assessment was done using the Harris Hip score.

Radiological assessment was carried out using RC Johnston’s criteria for uncemented cups.

Results: 52 revised cups in 48 patients were reviewed. Mean age was 71.6yrs, 21 males and 27 females. Mean follow up was 6 years (4 to 8 years). Average cup size was 64 mm (62 to 66).

Diagnosis at index operation was 10 Rheumatoid, and 42 osteoarthrosis. Average Harris Hip Score was 85 (excellent 35, good 11, fair 3, poor 3)

Radiological assessment showed excellent bony incorporation in all but the failures. There were 3 failures, 1 due to infection (revision was for infected primary THR), and 2 due to aseptic loosening in rheumatoid patients (both had significant cup malposition at revision). The major complications included 2 intraoperative fractures.

Conclusion: Intermediate term results of acetabular revisions, using large cups, without structural bone grafting, in our hands, are encouraging. Cup position at revision appears crucial for long-term survival.

A retrospective study of the development of the hip opposite a congenitally dislocated hip was carried out to identify at an early age those hips which would develop abnormally. Recognised radiological measurements were used showing the development of the joints with age. The development was compared with that of a control group of normal hips. Single measurements were shown to be unreliable in predicting the development of the hip. A simple hip ratio is proposed which predicts, at an early age and with a high degree of accuracy, the developmental outcome.