Surgery for Hip Displacement
Surgical Outcomes for Hip Displacement Reconstructive Surgery
Around 35% of individuals with cerebral palsy experience hip displacement during their lifetime. The risk of hip displacement in CP is associated with the Gross Motor Function Classification System (GMFCS) level. According to some studies, the incidence rate is found to be 0% at GMFCS level I and up to 90% at GMFCS level V. Parents may be interested in hip displacement reconstructive surgery for their child experiencing hip displacement. Parents may also be concerned that some people experience hip re-displacement, even after surgery. What is the risk of re-displacement after reconstructive surgery?
A recent paper reported on the surgical outcomes for bony hip displacement reconstructive surgery in non-ambulatory patients with CP based on a review of literature. Specifically, the paper looked at the re-displacement rate following Varus Derotation Osteotomy (VDRO), and a combination of VDRO plus Pelvic Osteotomy. VDRO is a procedure used to put the femoral head (ball of the hip joint) back in the correct position. Pelvic Osteotomy involves reshaping a shallow hip socket so that it accommodates the femoral head.
What were the results?
The re-displacement rate after reconstructive surgery was 16%, based on the data found in 28 studies (1540 hips). VDRO-alone showed a higher re-displacement rate than the combination of VDRO plus Pelvic Osteotomy (30% vs 12%). The average age of patients was 7.1 years in the VDRO-alone group and 9.5 years in the combination group.
According to the paper, the current data supports the combination surgery of VDRO plus Pelvic Osteotomy as the surgical intervention over VDRO-alone. The paper says more research in this area is needed to understand the effectiveness of reconstructive surgery, especially in ambulatory children with CP. Parents interested in treatment for their child’s hip displacement can talk to the child’s health care provider to learn more about options.
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