Long-term followup of total hip arthroplasty in patients with cerebral palsy.
BACKGROUND
Patients with cerebral palsy (CP) are at risk for hip arthrosis secondary to the loss of joint congruity.


OBJECTIVE
We asked whether THA relieved pain, improved function, and provided durable improvements.


METHODS
We retrospectively identified 56 patients (59 hips) with CP who had THAs for painful hips. Chart review determined the preoperative, postoperative, and current functional levels. All patients or caregivers completed a questionnaire, including a modified Gross Motor Function Classification System mobility scale and qualitative reports of pain and satisfaction. Pain levels were measured on a visual analog scale at three times: preoperative, postoperative, and current. The average age of the patients at the time of surgery was 30.6 years. Minimum followup was 2 years (average, 9.7 years; range, 2-28 years).


RESULTS
Pain relief was obtained in all patients. All patients returned to preoperative function (59) and 52 patients returned to prepain functional status (88%). Seven patients underwent acetabular component revisions, and two patients had a femoral stem component revision. The 2-year implant survival was 95%, and 10-year survivorship was 85%.


CONCLUSIONS
THA can provide durable relief and improved function in patients with CP with severe coxarthrosis.


METHODS
Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Raphael
Bradley S
BS
Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA. raphaelb@hss.edu
Dines
Joshua S
JS
Akerman
Meredith
M
Root
Leon
L
D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007592:Joint Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D051346:Mobility Limitation; D010146:Pain / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications; D020127:Recovery of Function; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult