HIP RESURFACING WITH FEMORAL OSTEOTOMY FOR PAINFUL SUBLUXED OR DISLOCATED HIPS IN PATIENTS WITH CEREBRAL PALSY

The purpose of the study was to assess the usefulness of this combination of operations in this challenging patient group. 18 patients (19 hips) with cerebral palsy and painful subluxed or dislocated hips underwent hip resurfacing with shortening and rotation osteotomy of the femur between 1999 and 2005. The mean age was 25 (range 14–59) and follow-up averaged 47 months. Eleven patients were quadriplegic, five were diplegic and two were hemiplegic. There were no infections. There were two plate cut-outs and two dislocations. All stabilised following necessary treatment. Four plates were removed after about one year. All quadriplegic and four of the diplegic patients were chair-bound pre-operatively. Their carers all felt that their comfort sitting had improved. Seventeen patients (eighteen hips) were pain-free at latest follow-up. One patient, whose plate had not been removed had some lateral tenderness on transferring, but no apparent pain on sitting. Three of the previously chairbound diplegic patients were able to stand and one was able to walk. As all eighteen of the carers were very satisfied with the outcome, this approach to the treatment of these challenging patients has proved promising