Total hip replacement in patients with neurological conditions.
Neurological conditions affecting the hip pose a considerable challenge in replacement surgery since poor and imbalanced muscle tone predisposes to dislocation and loosening. Consequently, total hip replacement (THR) is rarely performed in such patients. In a systematic review of the literature concerning THR in neurological conditions, we found only 13 studies which described the outcome. We have reviewed the evidence and discussed the technical challenges of this procedure in patients with cerebral palsy, Parkinson's disease, poliomyelitis and following a cerebrovascular accident, spinal injury or development of a Charcot joint. Contrary to traditional perceptions, THR can give a good outcome in these often severely disabled patients.
Cappagh National Orthopaedic Hospital, Finglas, Dublin, Ireland.
J M
JM
Queally
A
A
Abdulkarim
K J
KJ
Mulhall
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001177:Arthropathy, Neurogenic / Q000150:complications; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002493:Central Nervous System Diseases / Q000150:complications*; D002547:Cerebral Palsy / Q000150:complications; D005260:Female; D006621:Hip Joint / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications; D011051:Poliomyelitis / Q000150:complications; D011379:Prognosis; D011475:Prosthesis Failure; D013124:Spinal Injuries / Q000150:complications*; D020521:Stroke / Q000150:complications; D016896:Treatment Outcome; D055815:Young Adult