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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 10, 1267-1273.
doi: 10.1302/0301-620X.91B10.22934  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Right arrow Articles by Mulhall, K. J.

Total hip replacement in patients with neurological conditions

J. M. Queally, MRCS I, Registrar in Trauma and Orthopaedics1; A. Abdulkarim, MRCS, Research Fellow2; and K. J. Mulhall, FRCS I(Trauma & Orth), Associate Professor3

1 Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
2 Sports Surgery Clinic, Santry Demesne, Dublin 9, Ireland.
3 Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland.

Correspondence should be sent to Mr K. J. Mulhall; e-mail: kjmulhall{at}eircom.net

Neurological conditions affecting the hip pose a considerable challenge in replacement surgery since poor and imbalanced muscle tone predisposes to dislocation and loosening. Consequently, total hip replacement (THR) is rarely performed in such patients. In a systematic review of the literature concerning THR in neurological conditions, we found only 13 studies which described the outcome. We have reviewed the evidence and discussed the technical challenges of this procedure in patients with cerebral palsy, Parkinson’s disease, poliomyelitis and following a cerebrovascular accident, spinal injury or development of a Charcot joint. Contrary to traditional perceptions, THR can give a good outcome in these often severly disabled patients.






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