Abstract
Introduction: The purpose of this study was to evaluate the predictors of outcome of hip reconstruction in cerebral palsy and to review the trend in recovery over five years following operations.
Methods: 39 reconstructions in 22 patients [mean age 9.9 SD 2.1] with a mean follow up of 4.7 years were reviewed retrospectively. Information regarding diagnosis, preoperative function and symptoms, details of operation and the postoperative status were retrieved from the clinical records. Preoperative, postoperative and yearly follow up radiographs were reviewed to document acetabular index, Rimmer’s migration percentage (MP) and CE angle. 17 patients underwent simultaneous bilateral hip reconstruction. Femoral osteotomy was performed in all cases in the primary hip and in 17 cases in second hip. Acetabuloplasty was performed in 18 patients in the worst hip and only in 5 cases in the second hips.
Results: The mean preoperative MP in the worst hip was 81%. This improved to 30.7%. In the second hip it improved from 38% to 12.2%. The follow up measurements of the acetabular indices, MP and CE angle had a significant correlation with the postoperative measurements (p< 0.05). In 18 patients hip pain improved and in 14 patients sitting tolerance improved. Perineal hygiene improved in 7 patients following the operation. Graphs of trends in the MP and CE angle are presented. There was no correlation between preoperative presence of pelvic obliquity and post operative outcome. There was no significant difference in outcome in the groups of patients based on open reduction at the time of surgery.
Discussion and Conclusions: The final outcome of the reconstruction can be predicted consistently from the first postoperative radiograph. The quality of reduction at the time of operation is of paramount significance in ensuring long-term survival of the reconstruction.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
