Abstract
Introduction: The purpose of this study was to evaluate the predictors of outcome of hip reconstruction in cerebral palsy patients.
Methods: 71 hip reconstructions in 38 patients [mean age 9.7] were reviewed retrospectively. Information regarding pre- and postoperative status, and operative details were retrieved from the clinical records. Preoperative, postoperative and annual follow up radiographs were reviewed to document acetabular index, Rimmer’s migration percentage (MP) and CE angle.
Results: The mean MP improved from 84% to 43.8%. In 17 patients who underwent bilateral reconstruction the MP of the secondarily affected hips was improved from 38% to 12.2% The early follow up measurements of acetabular index, MP and CE angle had a significant correlation with the eventual postoperative outcome (p< 0.05). In a group of 22 patients hip pain was improved in 18 patients, sitting tolerance in 14, and perineal hygiene improved in 7 patients. There was no correlation between preoperative pelvic obliquity and open versus closed reduction with the eventual outcome.
Discussion: The final outcome of the reconstruction can be predicted consistently from the first postoperative radiograph (MP). The quality of reduction at the time of operation is of paramount significance in ensuring long-term survival of the reconstruction. Subluxed hips in general did better than dislocated hips. The hips showed gradual deterioration over time.
Correspondence should be addressed to BSCOS, c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London, WC2A 3PN
