A long term follow-up study (20-26 years after the original surgery) is presented of 7 patients who underwent a capsular arthroplasty according to the method of Colonna for congenital hip dislocation. Clinically and, in part also radiologically, the results were amazingly good. If we respect a few essential rules before, during and after the operation, all aiming at avoiding hyperpressure in the hip joint, the Colonna procedure may still be an alternative to more modern reconstructive procedures of the acetabulum. This is particularly true for congenital dislocations in the older child or unsuccessfully treated high residual subluxations. In both cases the cartilage of the acetabulum is altered and deformed to such an extent, that no method can make it fit the femoral head, which is also deformed.