Morphology of the acetabulum in congenital dislocation of the hip. Gross, histological and roentgenographic studies.

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Abstract
At autopsy, the hips of 6 infants who died soon after birth and had unilateral congenital hip dysplasia were found to have a cartilaginous ridge in the acetabulum which separated the hip socket into 2 sections. In 2 of the hips with a moderate degree of dysplasia and in 1 completely dislocated hip the ridge was formed exclusively by a bulge of acetabular cartilage. In 3 completely dislocated hips the ridge was formed by a bulge of acetabular cartilage covered by the inverted labrum. The acetabular cartilage showed signs of degeneration whereas the triradiate cartilage was normal. Examination of many newborn infants indicated that hip clicks are common and are not diagnostic of hip dysplasia. Diagnosis should be made only when the femoral head slides with a jolt over the acetabular ridge, causing a true positive Ortolani sign. Scattered ossification centers in the acetabular cartilage were seen on the roentgenograms of nearly half of 59 hips with congenital dislocation reduced after the child was 2 yr old, but less frequently in hips reduced at an earlier age.