INTRODUCTION: In recent years, the interest in hip shelf arthroplasty (HSA) has been increasing and the number of studies documenting long-term results with minimal complications has been growing. The aim of this study is to present long-term results of HSA and analyze the factors that influence them. MATERIAL AND METHODS: The group of 24 patients (38 hips) with a mean age of 30 years (range, 16 to 52 years), with acetabular dysplasia, was treated by HSA (Bosworth technique). The mean follow-up time for all hips was 26 years (range, 22 to 35 years). The endpoint of the follow-up was total hip arthroplasty. RESULTS: In all 38 hips, the positive effect of HSA lasted for at least 20 years. In 28 hips followed up on average for 24.5 years (range, 22 to 35 years), the positive effect still persisted at the latest follow-up. Three patients (3 hips), followed up for 26, 26 and 31 years, respectively, deteriorated in the last three years, but they rated their condition as good at the latest follow-up and did not require THA. Seven hips had to be converted to THA. The mean age of these patients at the time of HSA was 29 years (range, 16 to 41 years). The average interval between HSA and THA was 25 years (range, 22 to 31 years). In 3 converted hips, the subluxation was identified as a risk factor. No serious complication (infection, neurovascular injury) was recorded. Kaplan-Meier survival curve at 20-year follow-up was 100% in the study cohort and 70.1% in the worst-case scenario and at 30-year follow-up it was 79.6% in the study cohort and 70.1% in the worst-case scenario. CONCLUSION: Properly indicated and technically accurately performed HSA can provide very good long-term results. The best results can be expected in dysplastic spherical centered hips with minimal or no osteoarthritic changes (OAC).

Department of Orthopedics 1st Faculty of Medicine Charles University and the Central Military Hospital U Vojenské nemocnice 1200 Prague Czech Republic

Institute of Anatomy 1st Faculty of Medicine Charles University U Nemocnice 3 Prague Czech Republic

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