Acetabular Preparation and Insertion of the Dysplasia Birmingham Hip Resurfacing Cup

Abstract

This chapter concerns the dysplasia cup, which has been available for the past 10 years with the Birmingham Hip Resurfacing (BHR). There are many ways of dealing with the deficient acetabulum, including medialization of the acetabular component, use of a high hip center aiming to get better fixation for the acetabular component higher in the pelvis, and use of structural bone graft. In addition, many techniques of cages and constrained morcellized graft can also be used. These are discussed in Chapter 25. For patients with minor dysplasia, we use the techniques of medialization of the acetabular component and mild elevation of the hip joint center. Before the dysplasia cup was available, I used structural bone graft to support the acetabular component of the McMinn resurfacing cup in severe DDH. Since the advent of the dysplasia cup, I have not used a single structural bone graft in the acetabulum. This is not an easy implant to perform, but then severe acetabular dys-plasia is not an easy diagnosis to deal with well. Many of these patients are very young and deserve our best efforts to achieve a good bony reconstruction of their acetabulum and a good functional outcome.