DARthroplasty – brief history

König, 1891

In human medicine, the augmentation of the femoral head support by an extracapsular bone graft has been used for a very long time in the treatment of hip dysplasia. It was first described by König in 1891 and was the principal method of acetabular reconstruction during the first half of the 20 th century (1). Several techniques using this principle have been used. The main difference being the method used to stabilize the graft. This group of techniques are generally known by the term Shelf Acetabuloplasty, in the sense that the bone graft works as an extension of the true acetabulum. In recent decades the early diagnosis of the disease in humans permitting the correction by harnesses and by rotational osteotomies conferring hyaline cartilage coverage to the femoral head have reduced the number of shelf operations. Nevertheless, it is present in the armamentarium of many surgeons, being used mainly in late presentation cases (late childhood, adolescents and young adults) (1,2,3,4,5). It remains as one of the few alternatives in complex late presentation cases (1), as a rescue technique should the rotational osteotomies fail to correct the deficient coverage (6) and as probably one of the best options for severe late onset Legg-Calvé-Perthes disease (7,8,9,10,11,12,13). In recent years it has been performed using minimally invasive methods (14).


Slocum, 1998

In 1998 Barclay Slocum and Theresa Devine Slocum published the description and results of a shelf surgical technique for dogs that was named DARthroplasty (15). The name signifies Dorsal Acetabular Rim plasty. More than 300 hips were operated in their 6 year experience with the technique before publication (15). The technique is indicated, according to these authors, for dysplastic hips too far advanced (in the disease process) for triple pelvic osteotomy (TPO) but not yet candidates for end-stage salvage procedures (15).

Since this publication very little has been written about the DARthroplasty. The data was never collected to clarify it’s definitive place in Veterinary Surgery.





Staheli LT, Chew DE. Slotted acetabular augmentation in childhood and adolescence.
J Pediatr Orthop. 1992 Sep-Oct;12(5):569-80.

Fawzy E, Mandellos G, De Steiger R, et al. Is there a place for shelf acetabuloplasty in the management of adult acetabular dysplasia? A survivorship study.
J Bone Joint Surg [Br] 2005; 87-B:1197-202.

Summers BN, Turner A, Wynn-Jones CH. The shelf operation in the management of late presentation of congenital hip dysplasia.
J Bone Joint Surg [Br] 1988;70-B: 63-8.

Courtois B, LeSaout J, Lefevre C, et al. The shelf operation for painful acetabular dysplasia in adults: a propos of continuous series of 230 cases.
Int Orthop 1987;11: 5-11 (in French).

Hirose S, Otsuka H, Morishima T, et al. Long-term outcomes of shelf acetabuloplasty for developmental dysplasia of the hip in adults: a minimum 20-year follow-up study.
J Orthop Sci (2011) 16:698–703

Su Y, Wang M, Chang W. Slotted Acetabular Augmentation in the Treatment of Painful Residual Dysplastic Hips in Adolescents and Young Adults.
J Formos Med Assoc | 2008 • Vol 107 • No 9: 720-727

Kruse RW, Guille JT, Bowen Jr. Shelf arthroplasty in patients who have had Legg-Calvé Perthes disease: a study of long-term results.
J Bone Joint Surg [Am] 1991;73-A:1338-47.

Wright D, Perry D, Daniel C, et al. Shelf acetabuloplasty for Perthes disease in patients older than eight years of age: an observational cohort study.
Journal of Pediatric Orthopaedics B 2013; vol22 issue 2: 96-100

Domzalski M, Glutting J, Bowen R, et al. Lateral Acetabular Growth Stimulation Following a Labral Support Procedure in Legg-Calvé-Perthes Disease.
J Bone Joint Surg Am, 2006 Jul 01;88(7):1458-1466

Daly K, Bruce C, Catterall A. Lateral shelf acetabuloplasty in Perthes’ disease – A review at the end of growth.
J Bone Joint Surg [Br] 1999;81-B:380-4.

Osman M, Martin D, Sherlock D. Outcome of late-onset Perthes’ disease using four different treatment modalities.
J Child Orthop (2009) 3:235–242

Oh C, Rodriguez A, Guille JT, et al. Labral Support Shelf Arthroplasty for the Early Stages of Severe Legg-Calvé Perthes Disease. 
Am J Orthop. 2010;39(1):26-29.

Van Der Geest I, Kooijman M, Spruit M, et al. Shelf Acetabuloplasty for Perthe’s Disease: 12-Year Follow up.
Acta Orthopædica Belgica, Vol. 67 – 2 – 2001

Chiron P, Laffosse JM, Bonnevialle N. Shelf arthroplasty by minimal invasive surgery: technique and results of 76 cases.
Hip International / Vol. 17 no. 2 (suppl 5), 2007 / pp. S72-S82

Slocum B, Slocum T. D. DARthroplasty.
In: Bojrab, M. J., ed. Current Techniques in Small Animal Surgery, 4th Ed. Baltimore: Williams & Wilkins 1998: 1168 – 1170