Clin Orthop Surg.  2015 Mar;7(1):39-45. 10.4055/cios.2015.7.1.39.

Contemporary Ceramic Total Hip Arthroplasty in Patients with Cerebral Palsy: Does It Work?

• Yoon BH
• Lee YK
• Ha YC
• Koo KH

• KMID: 2069873
• DOI: http://doi.org/10.4055/cios.2015.7.1.39

Abstract

BACKGROUND
Adult patients with cerebral palsy (CP), who have advanced degenerative arthritis of the hip, have been treated with resection arthroplasty and arthrodesis. Although total hip arthroplasty (THA) has also been used as one of the alternative options, there are few studies on contemporary bearings used in THA. Therefore, we evaluated the results of the contemporary ceramic-on-ceramic THA in adult patients with CP.
METHODS
From January 2005 to December 2007, five adult CP patients (5 hips) underwent THA using contemporary ceramic-on-ceramic bearings. All patients were able to stand or ambulate with intermittent use of assistive devices at home. We retrospectively reviewed the series to determine the results of THA in terms of pain relief, improved function, and durability of prosthesis.
RESULTS
There were 3 men and 2 women with a mean age of 35.9 years. All patients had pain relief without decline in mobility postoperatively. One hip was dislocated, which was treated successfully with closed reduction and an abduction brace for 2 months. There was no ceramic fracture, loosening, or osteolysis during the mean follow-up of 6.8 years (range, 5.8 to 8.3 years).
CONCLUSIONS
Cementless THA using contemporary ceramic-on-ceramic bearings is a useful option for the treatment of advanced degenerative arthritis of the hip in ambulatory adults with CP.

Keyword

Cerebral palsy; Arthroplasty; Hip replacement; Osteoarthritis; Ceramics

MeSH Terms

Adult
Arthroplasty, Replacement, Hip/*methods
Biocompatible Materials
Ceramics
Cerebral Palsy/*complications
Female
Hip Joint/*surgery
Hip Prosthesis
Humans
Male
Osteoarthritis, Hip/etiology/radiography/*surgery
Prosthesis Design
Retrospective Studies
Treatment Outcome
Biocompatible Materials
Ceramics

Figure

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  Fig. 1 (A) Radiograph of a 20-year-old woman (patient 1) with spastic triplegia shows a highly dislocated hip with deficient and stiff acetabulum. (B) Radiograph at 6 years after total hip arthroplasty shows no evidence of implant loosening or osteolysis.

• 

  Fig. 2 (A) Radiograph of a 29-year-old man (patient 2) with spastic diplegia shows a highly dislocated hip. The leg length discrepancy is 8 cm on teleradiogram. (B) Radiograph at 6.5 years after total hip arthroplasty shows no evidence of implant loosening or osteolysis. The postoperative leg length discrepancy is 3.5 cm.

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