Between 1985 and 1998, 12 331 patients were included in the general neonatal ultrasound hip screening programme for developmental dysplasia of the hip (DDH). Patients who needed treatment (604) were compared with a second group of 73 unscreened children treated conservatively and surgically for DDH.The incidence of Graf sonographic hip types IIc to IV varied throughout the observation period. Femoral and pelvic osteotomies were almost entirely restricted to the unscreened group of patients. The six to ten per year recorded in the period 1985 to 1990 declined subsequently to three or less per year. The yearly admissions to hospital fell noticeably after six years of screening. Late presentations of DDH were reduced to three or less per year from 1990 to 1994, none between 1995 and 1998 and one or two per year from 2000.We conclude that general neonatal sonographic hip screening can reduce significantly surgical procedures, hospitalisation and late presentation of DDH.

The implantation of titanium alloy stems with a rough surface finish cannot be recommended because of its high aseptic loosening rate.

We introduce a new method to determine the anatomic rotation center of the hip. In total, 214 healthy hip joints were examined and statistically analyzed. As a reference point we used the intersection between Koehler's line and a line between the upper rims of the two foramina obturatoria. In relation to the reference point the anatomic hip center is localized 7.7% in vertical direction and 17.4% in horizontal direction for male individuals and 7.75 and 15.4% for female individuals, respectively. Those data were referred to the pelvic height. Our data can be used to determine the anatomic hip center in an easy and reliable way, not only for preoperative planning but also for retrospective investigations.

Storing autologous blood as whole blood (WB) has been proposed for increasing the cost-effectiveness of preoperative autologous blood donation programmes. However, experimental data suggest that autologous leucocytes might lead to immunomodulation similar to the effect attributed to allogeneic leucocytes. In a retrospective analysis, the postoperative outcome of 120 patients undergoing elective orthopaedic surgery and having donated up to two units of autologous WB (AWB) was compared with that of a control group of 52 patients, whose autologous donation had been processed into buffy coat-depleted red cell concentrates (RCC). At least one autologous unit, but no allogeneic units, had been transfused in all analysed patients. Donation schemes were equally efficacious in both groups. There was no significant difference in postoperative infection rates between the two groups. Overall rates were 7.7% in the RCC group and 8.3% in the WB group. Surgical, thromboembolic and other recorded complications, length of postoperative hospital stay and days of the use of antibiotics were also not significantly different between the two groups. The results of this study suggest that transfusion of up to two units of unmodified AWB is as efficacious as the transfusion of autologous RCC and does not negatively influence the postoperative outcome in elective orthopaedic surgery.

Our findings with a cemented mild grid blasted Titanium-Aluminum-Vanadium stem demonstrate excellent results unlike it was reported for cemented femoral components of similar alloy but different design and cementation philosophy.