Surface arthroplasty in a cerebral palsied patient with hip dysplasia and dislocation

Abstract

Hip dysplasia is considered to be an etiological factor in the progress of developmental osteoarthrosis of the hip. In patients with cerebral palsy, hip dislocation plus other anatomical alterations such as acetabular dysplasia, coxa valga, excessive femoral anteversion and muscle imbalance can be factors leading to coxarthrosis and pain. Total hip arthroplasty is a valuable method of treatment in some of these patients. However, sometimes young age, bone anatomy and shape, and the possible lack of stability of conventional designs in the context of big surgeries with multiple muscle releases and possible osteotomies make this arthroplasty a very difficult indication to reproduce as a surgeon. Hip resurfacing is a good option because it preserves as much bone stock as possible, doesn’t need corrective osteotomies and gives the prosthesis improved stability. The main concern about this type of prosthesis is the suspected lower survival rate of the femoral component, compared with regular total hip arthroplasties. We present a cerebral palsied patient with hip dysplasia who underwent resurfacing surgery. At a follow up one year after surgery, the patient was pain free, had recovered his motion and functionality, and was able to walk.