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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 8, 1007-1012.
doi: 10.1302/0301-620X.91B8.21808  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Autologous capping during resection arthroplasty of the hip in patients with cerebral palsy

M. Egermann, MD, Orthopaedic Surgeon1; L. Döderlein, MD, Orthopaedic Surgeon and Head of Pediatric Orthopaedics2; E. Schläger, MD, Consultant Orthopaedic Surgeon1; S. Müller, MD, Resident1; and F. Braatz, MD, Consultant Orthopaedic Surgeon1

1 Department of Orthopedic Surgery University of Heidelberg, Schlierbacher Landstrasse 200a, D-69118 Heidelberg, Germany.
2 Childrens Orthopaedic Hospital, Bernauer Straβe Aschau i, D-83229 Chiemgau, Germany.

Correspondence should be sent to Dr M. Egermann; e-mail: marcus.egermann{at}ok.uni-heidelberg.de

In patients with severe quadriplegic cerebral palsy and painful hip dislocation proximal femoral resection arthroplasty can reduce pain, but the risk of heterotopic ossification is significant. We present a surgical technique of autologous capping of the femoral stump in order to reduce this risk, using the resected femoral head as the graft.

A retrospective study of 31 patients (43 hips) who had undergone proximal femoral resection arthroplasty with (29 hips) and without autologous capping (14 hips) was undertaken. Heterotopic ossification was less frequent in patients with autologous capping, and a more predictable pattern of bony overgrowth was found.

For a selected group of non-ambulatory patients with long-standing painful dislocation of the hip, we recommend femoral resection arthroplasty over more complicated reconstructive operations. The risk of heterotopic ossification, which is a major disadvantage of this operation, is reduced by autologous capping.






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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General