Total hip arthroplasty for failed rotational acetabular osteotomy: a report of three cases.

Three female patients with osteoarthrotic hips received total hip replacement arthroplasties after failed rotational acetabular osteotomies (RAO) were reported. In the first case, there was necrosis of the thin acetabular fragment and a collapse of the large grafted iliac bone because of technical problems. The second case had residual development dislocation of the hip preoperatively which resulted in pseudoarthrosis and instability of the pubic bone postoperatively. This patient was considered to be a bad candidate for rotational acetabular osteotomy. The last case was 65 years old, too old to treat by osteotomy. Deterioration of the articular cartilage was expected. All of them were successfully treated with total hip arthroplasties. The ages of the patients, the stage of osteoarthrosis, the thickness of the osteotomized acetabular fragment, and the size of the grafted bone seemed to be factors influencing the outcome of the RAO.