title: Proximal femoral resection-interposition arthroplasty in cerebral palsy.
abstract: Hip dislocation is common in children with total body cerebral palsy. It is associated with pain, difficulty in seating and problems with perineal hygiene. We present a retrospective study of 15 patients who had undergone 21 proximal femoral resection-interposition arthroplasties between 1990 and 2005. The mean age at the time of surgery was 16.2 years (range 11-26 years). Mean follow-up was 3.4 years (range 1-7 years). Ninety percent of patients had pain relief. Perineal hygiene and sitting was improved in all cases. A lateral femoral head defect was noted in 90% of hips and was associated with pain, and significant degenerative changes. Twelve hips had heterotopic ossification (11 type-1, one type-2 and 0 type-3). No major complications were seen. We would submit that proximal femoral resection is a good salvage procedure for the painful, dislocated hip, with an excellent chance of resolving symptoms. The finding of a lateral femoral head defect on the radiograph is associated with significant degenerative changes.
authors.affiliation: The Orthopaedic Department, The Royal Hospital for Sick Children, Glasgow, UK. r1abu@hotmail.com
authors.forename: Rashid B
authors.initials: RB
authors.lastname: Abu-Rajab
authors.forename: George C
authors.initials: GC
authors.lastname: Bennet
mesh_terms: D000293:Adolescent; D000328:Adult; D001178:Arthroplasty / Q000379:methods*; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D005260:Female; D006617:Hip Dislocation / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies