Failure of Hip Reconstruction in Children With Cerebral Palsy: What Are the Risk Factors?

Background: The rates and risk factors contributing to failure after hip reconstruction among patients with cerebral palsy (CP) are not well established. In analyzing a large cohort of children with CP who underwent hip reconstruction, the objectives of this study are to establish (1) the failure rates and (2) associated risk factors. Methods: This retrospective study included chart and radiographic review of patients between the ages of 1 to 18, with a diagnosis of CP, who underwent a hip reconstructive procedure at a single children’s hospital over a 9-year period (2010 to 2018). Patients without at least 2 years of follow-up were excluded. Age at time of surgery, sex, Gross Motor Function Classification System (GMFCS), procedure(s) performed, preoperative migration percentage (MP), neck-shaft angle, and acetabular index (AI) were recorded. Failure was defined as need for revision surgery or a MP>50% on follow-up radiographs. Logistic regression and multiple-variable regression-type models were used to test for significance of risk factors. Results: Of the 291 hips in 179 patients (102 males, 77 females) that met inclusion criteria, 38 hips (13%) failed. Significant differences in the failure group were seen in age at time of surgery (6.2±3.2 vs. 8.1±3.2; P
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Cerbral Palsy Source Type: research