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This study assesses the long-term results of total hip arthroplasty in spastic cerebral palsy patients with painful hips.

May 16, 2026

The Evaluation of Long-Term Results of Treatment Using Total Hip Arthroplasty in Painful Hip in Cerebral Palsy Patients

Key Points

This study assesses the long-term results of total hip arthroplasty in spastic cerebral palsy patients with painful hips.
Between 2013 and 2024, 56 cerebral palsy patients (59 hips) underwent total hip arthroplasty.
Pain and function were evaluated using the Visual Analogue Scale (VAS) and Gross Motor Function Classification System (GMFCS) pre- and postoperatively.
Statistical analyses evaluated the influence of implant type, age, BMI, and radiological parameters on outcomes.
Significant improvement in GMFCS and VAS scores post-surgery (p < 0.001), indicating reduced pain and improved function.
Implant type did not significantly affect outcomes, although dual mobility cups showed a trend towards better results (p < 0.04).
No correlation observed between complications and BMI, age, spasticity or radiological factors.

Abstract

Keywords: Painful Hip Dislocation, Cerebral Palsy, Painful Hip, Spasticity, GMFCS, Ashworth Classification Background Hip dislocation in patients with cerebral palsy (CP) is a frequent condition, reported in 23–80% of cases, significantly affecting daily functioning, rehabilitation, and nursing care. More than half of these hips become painful. Total hip arthroplasty (THR) has been proposed as one treatment option, though earlier studies associated it with high complication and failure rates, often describing it as a salvage procedure. Objectives This study aimed to evaluate long-term outcomes of THR in spastic CP patients with painful hips, with or without dislocation. Outcomes were analyzed using the Gross Motor Function Classification System (GMFCS), Visual Analogue Scale (VAS), Ashworth scale, implant type, age, BMI, radiological parameters (Crowe scale, Migration Index), and complications. Methods Between 2013 and 2024, 56 patients with CP (31 females, 25 males; 59 hips) underwent THR in our department, with a mean age of 30 years. Spasticity was assessed using the Ashworth scale. Cone stems were implanted in 36 hips and trapezoidal stems in 23. Pain and function were evaluated pre- and postoperatively using the VAS and GMFCS scales, respectively. Results There was a statistically significant improvement in GMFCS and VAS scores after surgery (both p < 0.001), indicating reduced pain and improved function or ease of care. Implant type did not significantly affect outcomes or complication rates, although a trend toward better results with dual mobility cups was noted (p < 0.04). No statistical correlation was found between postoperative complications and BMI, age, spasticity, or radiological factors. Conclusions THR is an effective and relatively safe treatment for spastic CP patients with painful hip disorders. Most patients experienced pain relief and improved mobility or ease of daily care. Dual mobility implants may provide slightly better results, while stem type, age, BMI, and spasticity degree did not significantly influence outcomes.

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