Selected Instructional Course Lecture   |    
Total Hip Replacement for the Dislocated Hip
Greg Jaroszynski, MD, FRCS(C); Ian Woodgate, MBBS(Hons), FRACS(Orth); Khaled Saleh, BSc, MD, MSc, FRCS(C); Allan Gross, MD, FRCS(C)
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An Instructional Course Lecture, American Academy of Orthopaedic Surgeons
Greg Jaroszynski, MD, FRCS(C) 760 Brant Street, Unit 4, Burlington, ON L7R 4B7, Canada
Ian Woodgate, MBBS(Hons), FRACS(Orth) St. George Private Hospital Medical Centre, Suite 2 and 3, Level 5, 1 South Street, Kogarah, New South Wales 2217, Australia
Khaled Saleh, BSc, MD, MSc, FRCS(C) Department of Orthopaedic Surgery, University of Minnesota, Box 492, 420 Delaware Street S.E., Minneapolis, MN 55455
Allan Gross, MD, FRCS(C) Division of Orthopaedic Surgery, Mount Sinai Hospital, Suite 476A, 600 University Avenue, Toronto, ON M5G 1X5, Canada. E-mail address: allan.gross@utoronto.ca
Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in March 2001 in Instructional Course Lectures, Volume 50. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).
No benefits have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.

J Bone Joint Surg Am, 2001 Feb 01;83(2):272-272
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Total hip replacement for the patient with a dysplastic hip is difficult. Certain problems that are encountered during total hip replacement are more pronounced when the hip is completely dislocated. The classification that we find most practical is that of Hartofilakidis et al.1. Type-1 hips are those with dysplasia, in which the femoral head is still within the true acetabulum (Fig. 1Fig. 1). Type-2 hips are those with low dislocation, in which the femoral head is in a false acetabulum, the inferior lip of which is in contact with or overlaps the true acetabulum (Fig. 2Fig. 2). Type-3 hips are those with high dislocation, in which the false acetabulum has no contact with the true acetabulum (Fig. 3Fig. 3). This classification corresponds with the Crowe classification2 as follows: type-1 hips (dysplasia) correspond with Crowe type-I and II hips, type-2 hips (low dislocation) correspond with Crowe type-III hips, and type-3 hips (high dislocation) correspond with Crowe type-IV hips. Type-2 hips (low dislocation) and type-3 hips (high dislocation) present the surgeon with certain technical problems that must be addressed during the planning and implementation of total hip replacement. These problems are related to limb-length discrepancy, placement and coverage of the cup, the need for small femoral and acetabular components, and the surgical technique.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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