TOTAL HIP-ARTHROPLASTY IN CEREBRAL-PALSY - LONG-TERM FOLLOW-UP RESULTS

Patients with cerebral palsy frequently develop coxarthrosis after acq uired hip dislocation or dysplasia. Nineteen total hip arthroplasties (THA) were performed in 18 patients with cerebral palsy and end-stage hip degeneration. The average age at arthroplasty was 30 years (range, 16-52 years). All components were cemented, and four hips required bo ne graft augmentation of the deficient acetabulum. Spica casts were us ed in 16 of 18 patients to minimize the incidence of dislocation and t rochanteric nonunion. The average follow-up time was ten years (range, three to 17 years). Seventeen of 18 patients (94%) had pain relief an d improved function after arthroplasty. One stem loosened at three yea rs, and one acetabular component loosened at 15 years. One stem and on e acetabular component were revised for malposition. Survivorship anal ysis was 95% at ten years for loosening and 86% with removal for any r eason. Total hip arthroplasty can provide long-term relief and improve d function in cerebral palsy patients with severe coxarthrosis.