Objective To evaluate efficiency and safety of total hip replacement (THR) in the treatment of developmental dysplasia of the hip (DDH) in adult.Method From Jane 2005 to January 2011,a total of 30 patients (30 hips) of DDH underwent THR.The preoperative average Harris score 52.8 points (25 to 58 points).Results Follow-up period of 8 months to 5 years,the average time of 2.9 years.The postoperative average Harris score 88.9 points (75 to 96 points),good rate of 86.7％ (26/30),All the patiients were no femoral nerve palsy,,no infection,aseptic loosening and prosthesis subsidence and other complications.The ostoperative acetabular bone were healed.Conclusion THR is a good treatment method for DDH in adult,especially in patients with dislocation of the femoral head high.The key techniques for the THR are as follow so good preoperative plan.