title: Prosthetic interposition arthroplasty for the palliative treatment of end-stage spastic hip disease in nonambulatory patients with cerebral palsy.
abstract: We reviewed our experience in using a prosthetic arthroplasty for the treatment of painful degenerative arthritis in 11 nonambulatory patients (14 hips) with cerebral palsy. Age of the patients ranged from 11 to 20 years. Three patients had previously undergone a salvage procedure. Radiographic follow-up averaged 16 months (range, 4 months to 5 years). Ten of the hips remained located on the latest radiographs, and four of the hips dislocated within 4 months of the procedure. No patient exhibited migration or failure of the implants, although one patient exhibited periprosthetic osteolysis, which remained unchanged over a 4-year period. Clinical follow-up averaged 5 years (range, 2-6 years). Ten patients (13 hips) had complete relief of hip pain. Caretaker satisfaction was high for these patients, with all 10 caretakers stating that they would recommend the procedure. One patient continued to have persistent pain in the hip, and the caretaker stated that she would not recommend the procedure.
authors.affiliation: Department of Orthopaedic Surgery, Alfred I. duPont Institute, Wilmington, Delaware 19899, USA. pgabos@nemours.org
authors.forename: P G
authors.initials: PG
authors.lastname: Gabos
authors.forename: F
authors.initials: F
authors.lastname: Miller
authors.forename: M A
authors.initials: MA
authors.lastname: Galban
authors.forename: G G
authors.initials: GG
authors.lastname: Gupta
authors.forename: K
authors.initials: K
authors.lastname: Dabney
mesh_terms: D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000379:methods*; D011782:Quadriplegia / Q000209:etiology* / Q000601:surgery; D012720:Severity of Illness Index; D016896:Treatment Outcome