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Multicentric osteoregeneration is a new principle of osteoinduction [31a] which can be realized with the combination of collagen and fine dispersed hydroxyapatite ceramic particles (Collapat). This was histomorphometrically proved in the present study involving 14 rabbits with 28 6-mm-wide bore holes in the distal femoral condyles. With Collapat, an average of 5 times more new bone was regenerated than in the control defects without implant. The Wilcoxon matched-pairs signed-ranks test proved the positive effect of the implant Collapat on osteoregeneration with a significance of P less than 0.0001. At sites of Collapat insertion bone regeneration begins in the 2nd week, reaches its climax in the 3rd week, and is completed after the 4th week. in the course of development the histological picture is typified by a lively bone remodeling. Bone formation can be recognized in direct contact to the apatite granules. Foreign body or allergic reactions are not observed. Remodeling of the bone is not hindered by the slowly resorbable apatite granules. About 250 human implantations have been performed in our hospital since 1979, with good results and no negative effects.

Twenty-two patients (33 hips) with congenital dislocation of the hip were examined at an average of 26 years after combined acetabuloplasty and intertrochanteric varus derotation osteotomy. Seventeen patients had no problems despite physically demanding jobs and sporting activities in some cases. The CE angle was improved to the lower end of the normal range. The shaft-neck angle was corrected by 31 degrees to 120 degrees. Restoration to the normal valgus subsequently occurred and we found no evidence of subcapital coxa valga. Although there was an increase in the neck epiphysis angle 5 years after operation indicating a horizontal shift in the epiphyseal plate, most cases had normal hip joints. The incidence of postoperative avascular necrosis of the femoral head was 6%, and we found no increase in femoral deformities. Our long-term results show that the combination of acetabuloplasty and femoral osteotomy has no disadvantages, and is the best way of achieving optimal centring of the femoral head and stabilisation of the hip.

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