Our aim was to determine if the height of the cup, lateralisation or the abduction angle correlated with functional outcome or survivorship in revision total hip replacement in patients with a previous diagnosis of developmental dysplasia of the hip. A retrospective investigation of 51 patients (63 hips) who had undergone revision total hip replacement was performed. The mean duration of follow-up was 119 months. Forty-one patients (52 hips) were available for both determination of functional outcome and survivorship analysis. Ten patients (11 hips) were only available for survivorship analysis.

The height of the cup was found to have a statistically significant correlation with functional outcome and a high hip centre correlated with a worse outcome score. Patients with a hip centre of less than 3.5 cm above the anatomical level had a statistically better survivorship of the cup than those with centres higher than this. Restoration of the height of the centre of the hip to as near the anatomical position as possible improved functional outcome and survivorship of the cup.

1. The indications for amputation of all the toes for severe toe deformity in rheumatoid arthritis, hallux valgus and pes cavus are discussed.

2. The results of forty-seven amputations in twenty-eight patients are analysed: 93 per cent were found to be very satisfied with the operation.

3. The technique of the operation and the subsequent management are described. The importance of retaining full-length shoes fitted with metatarsal insoles and toe blocks to preserve a good gait and balance is emphasised.