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We followed up 76 consecutive hips with symptomatic acetabular dysplasia treated by acetabular shelf augmentation for a mean period of 11 years. Survival analysis using conversion to hip replacement as an end-point was 86% at five years and 46% at ten years. Forty-four hips with slight or no narrowing of the joint space pre-operatively had a survival of 97% at five and 75% at ten years. This was significantly higher (p = 0.0007) than that of the 32 hips with moderate or severe narrowing of the joint-space, which was 76% at five and 22% at ten years. There was no significant relationship between survival and age (p = 0.37) or the pre- and post-operative centre-edge (p = 0.39) and acetabular angles (p = 0.85). Shelf acetabuloplasty is a reliable, safe procedure offering medium-term symptomatic relief for adults with acetabular dysplasia. The best results were achieved in patients with mild and moderate dysplasia of the hip with little arthritis.

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Fifteen patients with Neer type II distal clavicle fracture were treated surgically, Operative treatment included open reduction and fixation of the proximal clavicular fragment to the coracoid process using a 6.5-mm canceilous screw and repair of the coracoclavicular ligaments. Fracture union occurred at a mean of 7 weeks postoperatively without any serious complications. All patients returned to the pre-injury level of activity with no residual pain or dysfunction.

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were implanted on a Sawbone® according to the manufacturer guidelines. All six implant systems were evaluated using a smaller and a larger glenosphere. The lowering and medialisation of the humerus with respect to the scapula after implantation of the implant was determined in neutral position (0 elevation and 0 internal rotation in scapular plane).The ROM was determined by the minimal and maximal elevation in the scapular and in 90 humeral plane, as by the maximal internal and external rotation at 30 and 60 elevation (glenoid plane) until bony contact. Results: With all implant systems the humerus was significantly lowered with respect to the scapula (p<0.05, mean: 38.8mm, SD: 4.4, range: 30.9; 43.6mm). With larger glenospheres, this lowering was significantly higher compared to smaller glenospheres (r¼ 0.94, p<0.05, mean: 2.1mm, SD:1.6).The humerus shifted medial (p<0.05, mean: 7.1mm, SD: 6.2) with a range of-1.5mm to 17.2 mm. The medialisation is positively correlated with the size of the glenosphere (r¼0.98, p<0.05, mean: 1.2mm, SD: 1.3). The total range of elevation depends on the orientation of the humerus in the vertical plane. The total range of elevation in the scapular plane ranges between 59.2 and 100.4 , whereas it ranges between 18.3 and 54.8 in the 90 humeral plane. The starting point, defined as the minimal elevation varies between 4.9 and 35 in the scapular plane, whereas it varies between 21.4 and 35.6 in the 90 humeral plane. The implantation of a large glenosphere resulted in a significant (p<0.05) enhancement of the total range of elevation and a reduction of the minimal elevation in both scapular an 90 humeral plane. Conclusions: There exists a wide variation in the measured parameters (position humerus, ROM) between the six most frequent implanted prosthesis. A larger glenosphere results in a better ROM in all different brands. These significant differences in ROM can be clinically important as it can result in impingement and restricted functionality of the humeroscapular joint.