According to this study it appears that it is quite common for these patients to have a surgery within three years of the conservative treatment, and in fact more than one half had such a surgery, including eight percent that completely failed the skin traction treatment. In this study this early surgery was a derotational femoral osteotomy. In addition to this early surgery, about one third of the hips had a later, after five years, open reduction surgery to further address unresolved hip dysplasia. Only a handful of patients in this study needed a second or third procedure, however later in lift total hip replacement becomes increasingly more common. In this particular study at the age of thirty only one percent of hips had been replaced, and at the age of fifty-two twenty-six percent of hips had been replaced. This study also indicates that current treatment is slightly more likely to include an open reduction at the time of diagnosis. So it does seem that with such a diagnosis, one surgery is common in childhood, followed by and increasing likelihood of having a total hip replacement after the age of thirty.