Surgical treatment using the method of total hip replacement in the system of rehabilitation of adolescents with cerebral palsy

Abstract

Purpose Improvement of the results of surgical rehabilitation of adolescent patients with cerebral palsy with subluxation and dislocation of the hip with the help of hip joint arthroplasty. Materials and methods The work is based on a retrospective analysis of the treatment outcomes in 12 children with cerebral palsy at the age of 13 to 17 years who underwent a total hip replacement surgery. The indication for the operation was the presence of a severe deformity of the joint components that could not be reconstructed and was accompanied by severe pain, loss of limb weight-bearing, significant limitation of motor abilities in patients over the age of 13 years. The components with cementless fixation were used. All patients underwent adductorotomy on the affected side. Results Neurological and vascular complications were not observed. Dislocation of the head and instability of the implant components was not observed. All patients showed an increased motor activity, relief of pain, a significant increase in the joint range of movements. Good and satisfactory functional results were obtained. The best results were obtained in level I-III patients according to the GMFCS system. Children of level IV achieved pain relief, improvement in the sitting posture, facilitation of care for them. Unsatisfactory results were not obtained. There were no complications during the operation and in the postoperative period. Conclusion According to the results, hip joint arthroplasty can be recommended for the rehabilitation of adolescent patients suffering from cerebral palsy.