title: Long-term results of hip arthroplasty in ambulatory patients with cerebral palsy.
abstract: Osteoarthritis (OA) secondary to dislocation and dysplasia is a common problem in patients with cerebral palsy. The purpose of this study was to evaluate the results of total hip replacement (THR) in ambulatory patients with cerebral palsy. Eighteen total hip arthroplasties were performed in 16 ambulatory patients with cerebral palsy. The patient's mean age at surgery was 42 +/- 8 years (range 32-58 years), and the mean follow-up was 10 +/- 6 years (range 2-18 years). Data were obtained by a standardised telephone interview. There was a significant postoperative reduction in pain on the NAS (narrative analogue scale) from 8.4 preoperatively to 1.1 postoperatively (p = 0.002). At follow-up no stem had been revised. Three cups were revised for aseptic loosening at two and six years, and one cup was revised for recurrent dislocation of the hip. One hip was revised for infection 12 years after the index surgery. One hip dislocated (three months postoperatively) and was treated by closed reduction. In ambulatory patients with cerebral palsy and secondary osteoarthritis of the hip THR can provide long-term pain relief and improved function. The rate of long term complications was moderate in this series; however, the dislocation rate was higher than in standard OA cases.
authors.affiliation: Orthopaedic University Hospital, University of Heidelberg, Heidelberg, Germany. kerstin.schroeder@ok.uni-heidelberg.de
authors.forename: Kerstin
authors.initials: K
authors.lastname: Schroeder
authors.forename: Christian
authors.initials: C
authors.lastname: Hauck
authors.forename: Bernd
authors.initials: B
authors.lastname: Wiedenhöfer
authors.forename: Frank
authors.initials: F
authors.lastname: Braatz
authors.forename: Peter R
authors.initials: PR
authors.lastname: Aldinger
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000379:methods* / Q000534:rehabilitation; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006617:Hip Dislocation / Q000209:etiology; D006622:Hip Prosthesis; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D011183:Postoperative Complications; D011475:Prosthesis Failure; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome