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background: To examine the properties of tissue embedment in the hip joint of patients with developmental dysplasia of the hip (DDH) in order to provide insight into the selection of surgical options.Methods: We studied 15 DDH patients with tissue embedment in hip joints.Embedded tissues in the acetabulum were excised during surgery and intra-articular changes were observed.Another 5 patients with avascular necrosis of the femoral head were also included in the study.Normal acetabular labrum,acetabular cartilages,and round ligaments of the femur were harvested from patients during surgery.All the specimens were labeled and stained by HE and observed using microscopy.Results: HE staining of all 15 embedded tissues were consistent with those of normal acetabular labrum,which were composed of fibrous cartilage.Normal acetabular cartilage and round ligaments of the femur were characterized as hyaline cartilage and fibrous connective tissue,respectively.Significant degeneration of the acetabular cartilage at the original sites of tissue embedment were observed after removal of the embedded tissues in all 15 DHH patients.Conclusion: These data suggest that embedded tissues in the hip joint are inverted acetabular labrum in symptomatic DDH patients.An inverted acetabular labrum could result in acetabular cartilage degeneration,which could accelerate the occurrence of hip osteoarthritis.Thus,we suggest excision of the inverted acetabular labrum is necessary when performing periacetabular osteotomy (PAO) in DDH patients.