TY - JOUR
T1 - A single-center retrospective review of factors influencing surgical success in patients with cerebral palsy undergoing corrective hip surgery
AU - Cottrill, Ethan J.
AU - Johnson, Deanna C.
AU - Silberstein, Charles E.
N1 - Publisher Copyright:
© 2019 - IOS Press and the authors. All rights reserved.
PY - 2019
Y1 - 2019
N2 - 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.
AB - 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.
KW - Cerebral palsy
KW - hip displacement
KW - migration percentage
KW - pain
KW - surgical success
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U2 - 10.3233/PRM-180553
DO - 10.3233/PRM-180553
M3 - Article
C2 - 31476176
AN - SCOPUS:85073183750
SN - 1874-5393
VL - 12
SP - 263
EP - 269
JO - Journal of pediatric rehabilitation medicine
JF - Journal of pediatric rehabilitation medicine
IS - 3
ER -