One-stage correction of the dysplastic hip in cerebral palsy with the San Diego acetabuloplasty: Results and complications in 104 hips

Ninety-two patients with cerebral palsy underwent a special type of pericap sular acetabuloplasty designed to correct the hip dysplasia that occurs in cerebral palsy. The osteotomy was performed as part of a combined procedure (including femoral osteotomy and soft-tissue releases). Retrospective anal ysis was performed on 75 of the children (104 hips from 1982 through 1995) with a mean follow-up of 6.9 years. Ninety-nine (95%) of the 104 hips remai ned well reduced at follow-up. There were no redislocations. If the preoper ative migration percentage was >70% (severe subluxation), improved results were noted in hips that had an open reduction with capsulorrhaphy. There we re 13 complications including intraarticular extension of the acetabuloplas ty (one) and avascular necrosis of the femoral head (eight hips, 8%). Indic ations for addition of a pericapsular acetabuloplasty include an open trira diate cartilage, acetabular dysplasia (acetabular index >25 degrees), and s ubluxation or dislocation with a migration percentage of >40%. Even hips wi th relative incongruity and some deformity of the femoral head can be succe ssfully treated with this combined approach.