Affiliations: [a] Division of Pediatric Orthopaedics, The Johns Hopkins Children’s Center, Baltimore, MD, USA | [b] Department of Physical Therapy, Kennedy Krieger Institute, Baltimore, MD, USA
Correspondence:
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Corresponding author: Ethan J. Cottrill, Division of Pediatric Orthopaedics, The Johns Hopkins Children’s Center, 1800 Orleans St, Rm 7354, Baltimore, MD 21287, USA. Tel.: +1 410 502 8226; E-mail: ecottri1@jhmi.edu.
Abstract: PURPOSE: To identify factors associated with success of corrective bony hip surgery among patients with cerebral palsy (CP). METHODS: A retrospective review was conducted of medical records of patients diagnosed with CP and hip displacement who underwent surgery from 2004 to 2016 at the authors’ institution and who had a one-year minimum follow-up. Patient age, sex, Gross Motor Function Classification System (GMFCS) level, surgical procedure(s), type and extent of CP, presence of preoperative and postoperative hip pain, and hip migration percentages (MPs) were recorded. Surgical success was defined as a postoperative MP ⩽ 30% and no hip pain at final follow-up. RESULTS: Thirty-eight patients (55 hips) met the inclusion criteria. Mean age at surgery was 10.2 years (range, 2–24 years). Mean MP (standard deviation) improved from 64 ± 29% preoperatively to 22 ± 30% at a mean 1.7-year follow-up (p< 0.001). The absence of preoperative hip pain (p= 0.014), surgery after age 5 (p= 0.041), and a milder preoperative MP (p< 0.001) were significantly associated with surgical success. CONCLUSION: In patients with CP and hip displacement, early preventative correction of hip displacement after age 5 may improve clinical outcomes, though future studies are needed to provide more definitive clinical direction.
Keywords: Cerebral palsy, hip displacement, migration percentage, pain, surgical success
