NDLI: Total hip replacement in young non-ambulatory cerebral palsy patients.

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Total hip replacement in young non-ambulatory cerebral palsy patients.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Morin, C. Ursu, C. Delecourt, C.
Description	Author Affiliation: Morin C ( Institut Calot, Rue du Dr Calot, 62600 Berck sur Mer, France. Electronic address: cmorin@hopale.com.); Ursu C ( Institut Calot, Rue du Dr Calot, 62600 Berck sur Mer, France.); Delecourt C ( Institut Calot, Rue du Dr Calot, 62600 Berck sur Mer, France.)
Abstract	INTRODUCTION: The everyday life of a non-ambulatory adolescent or young adult with cerebral palsy can be severely impaired by a painful or stiff hip. The usual surgical solutions such as proximal femoral resection (PFR) are not entirely satisfactory for pain relief, and are mutilating. HYPOTHESIS: A retrospective study assessed the impact of total hip replacement (THR) on such impairment, on the hypothesis that it is more effective than PFR in relieving pain, without aggravating disability. PATIENTS AND METHODS: The surgical technique consisted in implanting a dual-mobility prosthesis with uncemented acetabular component and cemented femur, after upper femoral shaft shortening and short hip-spica cast immobilization. Forty THRs were performed in 33 patients, including 31 with multiple disability. Follow-up assessment focused on change in functional status, pain, and range of motion. RESULTS: Mean follow-up was 5 years. Pain was more or less entirely resolved. Improvement in range of motion was less striking, and there was no significant change in functional status. There were 2 general, 2 septic and 10 mechanical complications, 6 of which required surgical revision. DISCUSSION: In non-ambulatory cerebral palsy, THR provided much better alleviation of pain than found with PFR treatment. It should be reserved for patients able to withstand fairly long surgery and with femur size compatible with implantation of a femoral component, however small. LEVEL OF EVIDENCE: IV, retrospective study.
File Format	HTM / HTML
Issue Number	7
Journal	Orthopaedics & Traumatology: Surgery & Research
Volume Number	102
e-ISSN	18770568
Language	English
Publisher	Elsevier
Publisher Date	2016-11-01
Publisher Place	France
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Orthopedics Discipline General Surgery Discipline Traumatology
Content Type	Text
Resource Type	Article

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