Introduction: Operative treatment of secondary osteoarthritis due to congenital hip disease (CHD) in adults presents a challenging issue. Various classifications have been proposed for congenital hip disease in search for the best treatment option. Aim of this prospective study is to find measurements important in preoperative planning and their correlation with postoperative results.

Materials and Methods: We have included 64 patients (70 hips) with CHD consecutively scheduled for operation. Preoperatively congenital hip disease was classified according to Crowe, Hartofilakidis and Eftekhar and center of rotation was determined using Ranawat’s method. Distance between ideal and actual center rotation was measured. Further, distance between medial acetabular wall and medial pelvic rim (medial bone bulk) in the line of ideal center of rotation was measured. Another measurement was distance between ideal acetabular roof point and medial pelvic rim. On the postoperative radiographs centre of the femoral head was recorded.

Correlation between Crowe, Hartofilakidis and Eftekhar classifications with distance between ideal and postoperative center rotation and medial bone bulk were calculated using Pearson correlation. Correlation was also analyzed using information about distance between ideal acetabular roof point and medial pelvic rim.

Results: Data analysis showed that there is the strongest connection between degree of CHD determined using Eftaker classification and distance between ideal and actual rotation center (r=0.417, p=0.011). Crowe and Hartofilakidis classifications also shows statistically significant connection, however not that strong (r= 0.384, p=0.021 for Crowe and r=0.373, p=0.025 for Hartofilakidis). Eftaker classification shows the strongest correlation with medial bone bulk r=0.425, a p=0.010. Similar is Crowe classification (r=0.341, p=0.042), while there is no statistically significant correlation with Hartofilakidis classification. Results also shows that when there is higher degree of congenital hip disease there is thinner bone bulk in line of ideal acetabular roof (for Crowe r= −0.360, p=0.031, for Hartofilakidis r= −0.354, p=0.34).

Conclusion: Results show that severity of dysplasia according to Crowe, Hartofilakidis and Eftekhar correlates with postoperative position of rotation center. Eftekhar classification gives the best insight to how much medial bone bulk is available. For bone bulk on the acetabular roof predictions can be made using both Crowe and Hartofilakidis system. However, one classification still does not provide with all information we found important for correct endoprothesis placement in relation to center of rotation especially about acetabular depth, and bone mass on the medial acetabular wall and acetabular roof.

Aims of the study: The purpose of this paper was to evaluate the long term results of the open Bankart procedure for an anterior shoulder instability in heterogenic non selected patients.

Material and Methods: Hundred and seventy seven patients were operated on at our instutution using open Bankart technique without using suture anchors, between 1993 and 2002. Hundred and sixty nine patients were evaluated. Average follow up was nine years and seven months (4–13 years). Average age at the time of operation was 27 (15 – 67). 89 % of shoulders had more than 3 dislocations, 60 % had more than 10 and 37 % more than 20 dislocations. American Shoulder and Elbow Society Scoring System and Constant Scoring System were used for assessment.

Results: 155 patients (92 %) had Bankart lesion and 150 patients (89%) had Hill-Sachs lesion. Five patients (2.9%) had redislocation of the operated shoulder caused by new trauma, two of them underwent reoperation. 164 patients were satisfied and very satisfied with the results. None of patients needed a shoulder arthroplasty because of symptomatic osteoarthritis. Average Constant score was 92 and American Shoulder and Elbow Society Scoring System was 90. Average loss of external rotation in adduction was 6 degrees and loss of external rotation in 90 degrees abduction was 3 degrees comparing to contra lateral shoulder.

Discussion/Conclusion: The Bankart procedure for anterior shoulder instability gives reliable long-term results.