Outcomes of Total Hip Arthroplasty for Painful Spastic Hip in Patients Who Have Cerebral Palsy: A Retrospective Cohort Study with Two to Eight Years of Follow-up.

Abstract

Hip dislocation associated with increased spasticity is a frequent condition in patients who have cerebral palsy (CP) that contributes to the early development of osteoarthritis (OA) and pain in this population. Total hip arthroplasty (THA) has been established as an effective treatment for osteoarthritis; however, there remains limited evidence on clinical outcomes and complication rates in patients who have CP. The purpose of our study was to evaluate the outcomes beyond two years after THA in patients who have CP and painful spastic hips. This retrospective study included 56 patients (60 hips) who underwent THA between 2013 and 2023 at a single orthopaedic department, with a minimum follow-up period of two years. Patients underwent both clinical and radiographic evaluation. The visual analog scale (VAS), Gross Motor Function Classification System (GMFCS), and the modified Ashworth scale (MAS) were assessed pre- and postoperatively. All complications were recorded and analyzed. On the last follow-up, VAS scores were significantly reduced (P < 10^-10), with the median value falling from 8.0 (interquartile range, 2.0) preoperatively to 0 postoperatively. The analysis did not demonstrate a statistically significant increase in the complication rate among patients who had pronounced spasticity (MAS III to IV) and reduced mobility (GMFCS IV to V). Our findings indicate that THA represents a promising and effective treatment option for managing painful spastic hip deformities in patients who have CP without increasing the risk of potential complications.