Effect of surgery on the nontreated hip in severe cerebral palsy

We studied the fate of the nonoperated hip in 35 patients with cerebral pal sy who underwent surgical stabilization for unilateral hip subluxation (24 patients) or dislocation (11 patients). Review of medical records and radio graphs was performed and analysis was accomplished on the effect of preoper ative and radiographic variables on the radiographic outcome of the nonoper ated hip. The average age at surgery was 5.5 years and at follow-up was 9.7 years, with an average follow-up of 4.2 years. Before subsequent surgery ( in 15 non-operated hips) or at follow-up, 10 of the nonoperated hips were d islocated and 16 hips were subluxated. Hips were stable and less likely to have surgery if they had a lower initial migration index and higher center edge angles. We conclude that there are few indications for unilateral hip surgery in patients with diplegia or quadriplegia undergoing initial hip st abilization surgery, especially if any degree of dysplasia is present.