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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 10, 1363-1368.
doi: 10.1302/0301-620X.89B10.18446  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Bilateral hip reconstruction in severe whole-body cerebral palsy

TEN-YEAR FOLLOW-UP RESULTS

M. J. Barakat, BSc(Hons), MBChB, MRCS, Orthopaedic Specialist Registrar1; T. While, MBChB, Junior Doctor1; J. Pyman, MCSP, Superintendent Physiotherapist1; M. Gargan, MA, FRCS(Orth), Consultant Orthopaedic Surgeon1; and F. Monsell, FRCS(Orth), Consultant Orthopaedic Surgeon1

1 Bristol Royal Hospital for Children, Paul O’Gorman Building, Upper Maudlin Street, Bristol BS2 8BJ, UK.

Correspondence should be sent to Mr F. Monsell; e-mail: Fergal.Monsell{at}ubht.nhs.uk

The results of a functional, clinical and radiological study of 30 children (60 hips) with whole-body cerebral palsy were reviewed at a mean follow-up of 10.2 years (9.5 to 11). Correction of windsweep deformity of the hips was performed by bilateral simultaneous combined soft-tissue and bony surgery at a mean age of 7.7 years (3.1 to 12.2).

We were able to recall 22 patients; five had died of unrelated causes and three were lost to follow-up. Evaluation involved interviews with patients/carers and clinical and radiological examination.

The gross motor functional classification system was used to assess overall motor function and showed improvement in seven patients. Of the 12 patients thought to have pain pre-operatively, only one had pain post-operatively. Improved handling was reported in 18 of 22 patients (82%). Those with handling problems were attributed by the carers to growth of the patients. All patients/carers considered the procedure worthwhile. The range of hip movements improved, and the mean windsweep index improved from 50 pre-operatively to 36 at follow-up.

The migration percentage and centre-edge angle were assessed on plain radiographs. Radiological containment improved, the mean migration percentage improved from 50 pre-operatively to 20 at follow-up and the mean centre-edge angle improved from –5° to 29°.

No statistical difference was noted between the three-year and ten-year follow-up results, indicating that the improvements in clinical and radiological outcome had been maintained.




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M. Egermann, L. Doderlein, E. Schlager, S. Muller, and F. Braatz
Autologous capping during resection arthroplasty of the hip in patients with cerebral palsy
J Bone Joint Surg Br, August 1, 2009; 91-B(8): 1007 - 1012.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General