Contemporary ceramic total hip arthroplasty in patients with cerebral palsy: does it work?
BACKGROUND
Adult patients with cerebral palsy (CP), who have advanced degenerative arthritis of the hip, have been treated with resection arthroplasty and arthrodesis. Although total hip arthroplasty (THA) has also been used as one of the alternative options, there are few studies on contemporary bearings used in THA. Therefore, we evaluated the results of the contemporary ceramic-on-ceramic THA in adult patients with CP.


METHODS
From January 2005 to December 2007, five adult CP patients (5 hips) underwent THA using contemporary ceramic-on-ceramic bearings. All patients were able to stand or ambulate with intermittent use of assistive devices at home. We retrospectively reviewed the series to determine the results of THA in terms of pain relief, improved function, and durability of prosthesis.


RESULTS
There were 3 men and 2 women with a mean age of 35.9 years. All patients had pain relief without decline in mobility postoperatively. One hip was dislocated, which was treated successfully with closed reduction and an abduction brace for 2 months. There was no ceramic fracture, loosening, or osteolysis during the mean follow-up of 6.8 years (range, 5.8 to 8.3 years).


CONCLUSIONS
Cementless THA using contemporary ceramic-on-ceramic bearings is a useful option for the treatment of advanced degenerative arthritis of the hip in ambulatory adults with CP.
Department of Orthopaedic Surgery, KEPCO Medical Foundation KEPCO Medical Center, Seoul, Korea.
Byung-Ho
BH
Yoon
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Young-Kyun
YK
Lee
Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
Yong-Chan
YC
Ha
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Kyung-Hoi
KH
Koo
D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001672:Biocompatible Materials; D002516:Ceramics; D002547:Cerebral Palsy / Q000150:complications*; D005260:Female; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011474:Prosthesis Design; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome
D001672:Biocompatible Materials
Arthroplasty; Ceramics; Cerebral palsy; Hip replacement; Osteoarthritis