Bilateral hip reconstruction improve hip stability, pelvic balance and mobility function in children with cerebral palsy

Background: Bilateral hip reconstructive surgery for hip displacement of children with cerebral palsy still be contro-versial.The objective of this study to report the outcome of bilateral hip surgery with varus derotation and shortening of the proximal femur and Dega pelvic osteotomy in radiography and mobility function of children with spastic diplegia and quadriplegia.Methods: We retrospectively reviewed 49 patients with spastic diplegia or quadriplegia who underwent bilateral hip reconstruction at minimum follow up of 24 months.Surgical outcomes were assessed on potential in correction of hip displacement by following migration percentage and pelvic obliquity by following migration percentage difference and pelvic obliquity angle.Mobility function improvement was assessed on the basis of sifting, standing and walking capa-bility before and after surgery.The effect of preoperative migration percentage, age at surgery, GMFCS level and pelvic obliquity angle on surgical outcome were assessed by logistic regression analysis.Result: 85.7% of the patients became normal hip coverage (MP<33%) and 45% of the patients who have pelvic obliq-uity became balance pelvis at 2 years after surgery.Migration percentage, migration percentage difference and pelvic obliquity angle reduced significantly.71% of the patients had improvement in sitting, 51% improved in standing and 12% improved in walking function.Preoperative migration percentage was only influential risk factor with respect to postoperative outcome. Conclusion:Bilateral hip reconstruction can correct hip displacement problem either bilateral or unilateral displace-ment into normal hip coverage by 90% and decrease pelvic obliquity significantly as well as improve remarkably in sitting and standing function of the patients with spastic diplegia and quadriplegia.