Autologous capping during resection arthroplasty of the hip in patients with cerebral palsy.
In patients with severe quadriplegic cerebral palsy and painful hip dislocation proximal femoral resection arthroplasty can reduce pain, but the risk of heterotopic ossification is significant. We present a surgical technique of autologous capping of the femoral stump in order to reduce this risk, using the resected femoral head as the graft. A retrospective study of 31 patients (43 hips) who had undergone proximal femoral resection arthroplasty with (29 hips) and without autologous capping (14 hips) was undertaken. Heterotopic ossification was less frequent in patients with autologous capping, and a more predictable pattern of bony overgrowth was found. For a selected group of non-ambulatory patients with long-standing painful dislocation of the hip, we recommend femoral resection arthroplasty over more complicated reconstructive operations. The risk of heterotopic ossification, which is a major disadvantage of this operation, is reduced by autologous capping.
Egermann
M
M
Department of Orthopedic Surgery University of Heidelberg, Schlierbacher Landstrasse 200a, D-69118 Heidelberg, Germany.
Döderlein
L
L
Schläger
E
E
Müller
S
S
Braatz
F
F
D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D002547:Cerebral Palsy / Q000150:complications*; D005260:Female; D005270:Femur Head / Q000002:abnormalities / Q000601:surgery*; D006617:Hip Dislocation / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000517:prevention & control*; D010147:Pain Measurement; D011859:Radiography; D012189:Retrospective Studies; D055815:Young Adult