[Hip joint status in adult patients with cerebral palsy]

Abstract

Introduction: In cerebral palsy, femoral head migration is defined as the loss of coverage of the femoral head by the acetabulum and is measured using the Reimer index. Surgical treatment can be preventive, reconstructive, or salvage, and failure rates of surgery are high and related to the severity of cerebral palsy. The aim of our work is to assess the incidence of hip migration in our series of adult patients with cerebral palsy, to determine the outcome of those who have undergone surgery, and to establish recurrence rates after the various surgical techniques.

Material and methods: We designed a retrospective observational study to determine the hip status of adult patients with cerebral palsy visiting the Unit between 2008 and 2021.

Results: The overall incidence of hip displacement was 75%, patients with more extensive disability (GMFCS IV and V) were more predisposed to dislocation, also more severe. Soft tissue surgery made up 49.5% of the operations performed with a failure rate of up to 82%. Reconstructive surgery was performed in 45.5% of cases with a failure rate of more than 86%.

Conclusion: The current hip surveillance programmes have been implemented to improve follow-up and interventions in hip displacement, with the objective of maintaining optimal acetabular coverage and reducing the failure rate of potential surgeries.

Keywords: Cerebral palsy; Cirugía de cadera; Hip dislocation; Hip migration; Hip surgery; Luxación de cadera; Migración de cadera; Outcomes; Parálisis cerebral; Resultados.