Total hip replacement surgery is a safe and effective treatment strategy for patients with cerebral palsy, offering a significant improvement in quality of life, according to a study titled “Good outcome of total hip replacement in patients with cerebral palsy,” recently published in the journal Acta Orthopaedica.
Patients with cerebral palsy are often burdened with painful hips as a result of muscle imbalance around the hip and eventual dislocation. Patients experience pain, but also problems while walking and sitting, and are therefore often submitted to hip surgery as a treatment. However, this surgical procedure in cerebral palsy subjects is considered high-risk, and its outcomes are largely unknown.
Now, researchers determined the incidence of total hip replacement in cerebral palsy patients, and clinical outcomes after the surgery. To this end, the research team combined Hospital Episode Statistics (HES) records and the National Joint Registry for England and Wales, and was able to identify 389 patients who underwent hip replacement.
The outcome in patients with cerebral palsy was compared to outcomes in patients without the condition in 425,813 subjects. Reasons for revision were quantified as patient-time incidence rates, and patient-reported outcomes were collected before and six months after surgery.
As authors had hypothesized, revision rates were higher in cerebral palsy patients compared to those without the disease. Specifically, the cumulative probability of revision at five years post-surgery was 6.4 percent for the cerebral palsy cohort, decreasing to 2.9 percent in the non-cerebral palsy group.
Patient-reported outcomes also showed worse pain and function preoperatively in cerebral palsy patients. On the other hand, postoperative improvement was the same between both groups. The median improvement in Oxford hip score at six months was 23 in the cerebral palsy cohort and 21 in the non-cerebral palsy cohort.
The vast majority of the cerebral palsy patients (91 percent) reported high satisfaction with the surgery outcomes. Importantly, mortality rates were similar between both groups analyzed (cerebral palsy versus non-cerebral palsy cohorts), suggesting that total hip replacement surgery is safe to perform in these patients.
In conclusion, the results suggested that hip replacement surgery is a safe and effective strategy for cerebral palsy patients, demonstrating acceptable implant revision rates.