Contemporary Ceramic Total Hip Arthroplasty in Patients with Cerebral Palsy: Does It Work?

The muscle imbalance in cerebral palsy (CP) leads to flexion-adduction contracture of the hip, increased femoral anteversion, coxa valga, hip dysplasia and dislocation. Fifty to 75 percent of adult patients with CP have secondary degenerative arthritis of the hip, hip related gait disturbance, and difficulty with perineal hygiene. 1,2) Surgical options for pediatric patients include open reduction, femoral or pelvic osteotomies, and additional tendon releases or transfers. However, degenerative arthritis of the hip develops with age, and adult patients have been treated with resection arthroplasty, arthrodesis, and replacement arthroplasty. Resection arthroplasty and arthrodesis should be reserved only for patients who are unable to walk and whose functional needs include improved hygiene and ease of positioning. Total hip arthroplasty (THA) offers pain relief, improved motion, comfortable gait, and high level of activity. lthough there are limited reports on THA in CP patients, mid-and long-term follow-up studies of THA in CP patients have reported satisfactory pain relief and improved walking in most of the patients. 6,7) However, these patients are often very young and frequently have muscle spasticity and hip contracture. Although they have a low level of activity and often use crutches, the 10-year survivorship of THA with use of conventional metal-on-polyethylene articulation with cemented or hybrid component was 86% to 95%. The 10-year survival improved up to 99% after the use of this articulation with-Background: Adult patients with cerebral palsy (CP), who have advanced degenerative arthritis of the hip, have been treated with resection arthroplasty and arthrodesis. Although total hip arthroplasty (THA) has also been used as one of the alternative options, there are few studies on contemporary bearings used in THA. Therefore, we evaluated the results of the contemporary ceramic-onceramic THA in adult patients with CP.