Hip development after surgery to prevent hip dislocation in cerebral palsy: a longitudinal register study of 252 children.
Acta Orthop
; 93: 45-50, 2022 01 03.
Article
em En
| MEDLINE
| ID: mdl-34662250
ABSTRACT
Background and purpose - Operative treatment of hip displacement in cerebral palsy (CP) includes adductor-psoas lengthening (APL) or varus derotation osteotomy (VDRO) of the proximal femur, sometimes combined with pelvic osteotomy. After both operations, there is a significant risk of relapse and need for reoperation. We used the migration percentage (MP) to compare the development of hip displacement after APL and VDRO. Patients and methods - All reported MP measurements for children treated with APL (n = 158) or VDRO (n = 94) and followed ≥ 3 years were obtained from the Swedish Surveillance Programme for CP. In children treated with bilateral surgery, the hip with the highest preoperative MP was analyzed. A mixed-effects model was used to estimate the development of MP with age for each child and the population mean. Results - The 104 hips that underwent APL without reoperation showed a gradually reduced MP postoperatively. The 54 hips that underwent a 2nd surgery with APL or VDRO because of redisplacement had a higher displacement rate preoperatively and continued displacement postoperatively but at a slower rate. The 94 hips that underwent VDRO showed an instantaneous decrease in MP postoperatively followed by a rate of increasing displacement. The 15 hips that underwent a 2nd VDRO had a higher rate of displacement both pre- and postoperatively. Interpretation - After APL, hip displacement either decreases or continues to increase but at a slower rate. After VDRO, the MP decreases momentarily but then gradually increases. The risk of reoperation is higher in children with a high preoperative displacement velocity and a high preoperative MP.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Reoperação
/
Paralisia Cerebral
/
Luxação do Quadril
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
Acta Orthop
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Suécia