Title : A five-year population-based study on the radiological outcomes of hip surgery in non-ambulatory children with cerebral palsy: Proximal femoral varus osteotomy versus combined femoral-pelvic osteotomy
Abstract:
Objectives: This study aimed to detail the radiological 5-year follow-up after reconstructive hip surgery in children with Cerebral Palsy (CP,) Gross Motor Function Classification System (GMFCS) levels III-V.
Methods: This study included 66 children at GMFCS levels III-V, followed by the national CP-surveillance program CPUP from the Skåne and Stockholm regions, who underwent reconstructive hip surgeries between 2001 and 2018. They all had proximal femoral varus osteotomies (FO), performed with or without concurrent pelvic osteotomy (FPO) as treatment for hip subluxation. They were followed for 5 years studying the radiographic parameters Migration Percentage (MP), Acetabular Index (AI), and Head Shaft Angle (HSA).
Results: During 2001–2018, 66 children (44 boys) underwent 86 femoral and/or pelvic osteotomies (38 FO, 10 bilaterally; 48 FPO, 8 bilaterally) and had a 5-year radiological follow-up; 26 and 40 children had ³1 FO or FPO as the primary skeletal surgery, respectively. The mean preoperative MP (50%±18% for FO and 62%±17% for FPO, P=0.001) and age at surgery (6.2±2.5 years for FO and 7.3±2.8 years for FPO, P=0.014) differed between procedures.
After 5 years, the mean MP was 26% for the FO group (26 children, 38 hips) and 25% for the FPO group (40 children, 48 hips). The 5-year radiological results for AI and HSA were also similar with a mean AI of 22 and 19 degrees for FO and FPO, respectively, and mean HSA of 152 and 149 degrees, respectively.
Conclusions: Despite more severe hip subluxation in the FPO group, the radiological results after FO and FPO were similar 5 years after surgery.
