Timely Surgical Intervention Leads to Better Sustained Coverage after Reconstructive Hip Surgery in Patients with Cerebral Palsy
Background: In up to 45–90% of non-ambulatory patients with cerebral palsy (CP), progressive hip migration can be observed. The goal of this study was to determine whether the implementation of a national hip surveillance guideline affected the outcome of hip reconstructions. Methods: We reviewed 48...
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| Format: | Article |
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MDPI AG
2024-02-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/11/3/272 |
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| author | Renée Anne van Stralen Dagmar Raymond Jacques Kempink Alexandra Frederika Titulaer Denise Eygendaal Max Reijman Jaap Johannes Tolk |
| author_facet | Renée Anne van Stralen Dagmar Raymond Jacques Kempink Alexandra Frederika Titulaer Denise Eygendaal Max Reijman Jaap Johannes Tolk |
| author_sort | Renée Anne van Stralen |
| collection | DOAJ |
| description | Background: In up to 45–90% of non-ambulatory patients with cerebral palsy (CP), progressive hip migration can be observed. The goal of this study was to determine whether the implementation of a national hip surveillance guideline affected the outcome of hip reconstructions. Methods: We reviewed 48 primary hip reconstructions at a median follow-up of 4.4 years. Surgical outcome was evaluated based on complication rates and radiographic evaluation postoperatively and at follow-up. Radiographic measurements included the migration percentage (MP), head–shaft angle and acetabular index. The impact of preoperative MP, postoperative MP, tone management, Gross Motor Function Classification System (GMFCS) classification and age on MP at follow-up were examined using a mixed model analysis. Results: A decrease in preoperative MP was noted, from a median of 75.0% (2014) to 39.0% (2020). Lower preoperative MP showed a significant correlation to lower MP postoperatively (<i>p</i> = 0.012). Postoperative MP was a significant independent predictor of a lower MP at follow-up (<i>p</i> = 0.002). Conclusions: This study shows an improvement in the timing of hip reconstruction in patients with CP after implementation of the hip surveillance guideline. A reduction in preoperative MP resulted in improved postoperative outcomes. A lower postoperative MP was the most important predictor for sustained containment of the hip. |
| first_indexed | 2024-04-24T18:26:31Z |
| format | Article |
| id | doaj.art-22ef93eb9e464a9bb8c2afdaa78ff8f6 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-04-24T18:26:31Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-22ef93eb9e464a9bb8c2afdaa78ff8f62024-03-27T13:30:59ZengMDPI AGChildren2227-90672024-02-0111327210.3390/children11030272Timely Surgical Intervention Leads to Better Sustained Coverage after Reconstructive Hip Surgery in Patients with Cerebral PalsyRenée Anne van Stralen0Dagmar Raymond Jacques Kempink1Alexandra Frederika Titulaer2Denise Eygendaal3Max Reijman4Jaap Johannes Tolk5Department of Orthopedics and Sports Medicine, Erasmus Medical Center Rotterdam—Sophia Children’s Hospital, Doctor Molewaterplein 40, 3015 GD Rotterdam, The NetherlandsDepartment of Orthopedics and Sports Medicine, Erasmus Medical Center Rotterdam—Sophia Children’s Hospital, Doctor Molewaterplein 40, 3015 GD Rotterdam, The NetherlandsDepartment of Rehabilitation Medicine, Rijndam Revalidatie, 3015 CN Rotterdam, The NetherlandsDepartment of Orthopedics and Sports Medicine, Erasmus Medical Center Rotterdam—Sophia Children’s Hospital, Doctor Molewaterplein 40, 3015 GD Rotterdam, The NetherlandsDepartment of Orthopedics and Sports Medicine, Erasmus Medical Center Rotterdam—Sophia Children’s Hospital, Doctor Molewaterplein 40, 3015 GD Rotterdam, The NetherlandsDepartment of Orthopedics and Sports Medicine, Erasmus Medical Center Rotterdam—Sophia Children’s Hospital, Doctor Molewaterplein 40, 3015 GD Rotterdam, The NetherlandsBackground: In up to 45–90% of non-ambulatory patients with cerebral palsy (CP), progressive hip migration can be observed. The goal of this study was to determine whether the implementation of a national hip surveillance guideline affected the outcome of hip reconstructions. Methods: We reviewed 48 primary hip reconstructions at a median follow-up of 4.4 years. Surgical outcome was evaluated based on complication rates and radiographic evaluation postoperatively and at follow-up. Radiographic measurements included the migration percentage (MP), head–shaft angle and acetabular index. The impact of preoperative MP, postoperative MP, tone management, Gross Motor Function Classification System (GMFCS) classification and age on MP at follow-up were examined using a mixed model analysis. Results: A decrease in preoperative MP was noted, from a median of 75.0% (2014) to 39.0% (2020). Lower preoperative MP showed a significant correlation to lower MP postoperatively (<i>p</i> = 0.012). Postoperative MP was a significant independent predictor of a lower MP at follow-up (<i>p</i> = 0.002). Conclusions: This study shows an improvement in the timing of hip reconstruction in patients with CP after implementation of the hip surveillance guideline. A reduction in preoperative MP resulted in improved postoperative outcomes. A lower postoperative MP was the most important predictor for sustained containment of the hip.https://www.mdpi.com/2227-9067/11/3/272hip surveillancecerebral palsyorthopedic surgery |
| spellingShingle | Renée Anne van Stralen Dagmar Raymond Jacques Kempink Alexandra Frederika Titulaer Denise Eygendaal Max Reijman Jaap Johannes Tolk Timely Surgical Intervention Leads to Better Sustained Coverage after Reconstructive Hip Surgery in Patients with Cerebral Palsy Children hip surveillance cerebral palsy orthopedic surgery |
| title | Timely Surgical Intervention Leads to Better Sustained Coverage after Reconstructive Hip Surgery in Patients with Cerebral Palsy |
| title_full | Timely Surgical Intervention Leads to Better Sustained Coverage after Reconstructive Hip Surgery in Patients with Cerebral Palsy |
| title_fullStr | Timely Surgical Intervention Leads to Better Sustained Coverage after Reconstructive Hip Surgery in Patients with Cerebral Palsy |
| title_full_unstemmed | Timely Surgical Intervention Leads to Better Sustained Coverage after Reconstructive Hip Surgery in Patients with Cerebral Palsy |
| title_short | Timely Surgical Intervention Leads to Better Sustained Coverage after Reconstructive Hip Surgery in Patients with Cerebral Palsy |
| title_sort | timely surgical intervention leads to better sustained coverage after reconstructive hip surgery in patients with cerebral palsy |
| topic | hip surveillance cerebral palsy orthopedic surgery |
| url | https://www.mdpi.com/2227-9067/11/3/272 |
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