title: Unilateral varus osteotomy of the proximal femur in children with cerebral palsy: a five-year follow-up of the development of both hips.
abstract: BACKGROUND
  Varus osteotomy of the proximal femur (VOPF) is one treatment option to prevent hip dislocation in children with cerebral palsy (CP). It is questioned whether the osteotomy should be performed in the displaced hip only, or if it should be performed bilaterally to prevent later displacement of the contralateral hip. CPUP is a register and healthcare programme for children with CP that was initiated in 1994 in southern Sweden. In the programme, range-of-motion and radiographic examination of the hips is performed regularly. These data have been analysed preoperatively and for 5 years postoperatively in children treated with unilateral VOPF.
  
  
  METHODS
  Children with CP living in the counties of Skåne and Blekinge in the south of Sweden, who were treated with unilateral VOPF at least 5 years ago, were included in the study. The degree of hip displacement and the range of hip motion were analysed preoperatively and after 5 years. Repeat hip operations after the index operation were recorded.
  
  
  RESULTS
  Twenty-four children fulfilled the inclusion criteria. Mean age at index operation was 7.6 (2.8-13.2) years. No child died within 5 years postoperatively, and no child was lost from follow-up. At follow-up after 5 years, 2 of the 24 children had been operated on with VOPF in the contralateral hip. The range of motion in both hips decreased, but the difference between the index hip and the contralateral hip did not change significantly.
  
  
  CONCLUSIONS
  Children with CP and unilateral hip displacement have a low risk of later contralateral displacement after being operated on with unilateral VOPF. This supports healthcare programmes that advocate unilateral VOPF in children with unilateral hip displacement.
authors.affiliation: Department of Orthopaedics, University Hospital, Lund University, 221 85 Lund, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Larsson
authors.forename: Gunnar
authors.initials: G
authors.lastname: Hägglund
authors.forename: Philippe
authors.initials: P
authors.lastname: Wagner
keywords: Bilateral; Cerebral palsy; Displacement; Hip; Osteotomy