Acetabular Remodeling After a Varus Derotational Osteotomy in Children With Cerebral Palsy
| Autor: | Frank M. Chang, Eduardo N. Novais, Julie Ma, James D. Ingram, Zhaoxing Pan |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Radiography Osteotomy Bone remodeling Cerebral palsy 03 medical and health sciences 0302 clinical medicine Medicine Hip Dislocation Humans Orthopedics and Sports Medicine Child Retrospective Studies Hip dysplasia 030222 orthopedics business.industry Cerebral Palsy Gross Motor Function Classification System Retrospective cohort study Acetabulum General Medicine medicine.disease Surgery Child Preschool Pediatrics Perinatology and Child Health Normal children Female Bone Remodeling business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of pediatric orthopedics. 36(2) |
| ISSN: | 1539-2570 |
| Popis: | BACKGROUND The optimal surgical intervention for hip dysplasia in cerebral palsy (CP) is controversial. The purpose of this study was to determine (1) whether an isolated varus derotation osteotomy (VDRO) for the treatment of CP hip dysplasia allows for acetabular remodeling as measured by acetabular depth ratio (ADR), (2) the predictive factors for acetabular remodeling after an isolated VDRO for the treatment of CP hip dysplasia, and (3) to establish the normal ADR in typical children for comparison. METHODS Eighty-seven CP patients (174 hips) treated with an isolated VDRO between 2003 and 2009 were retrospectively reviewed. The average age at surgery was 4.6 years (range, 2.4 to 10.6 y) and the average follow-up period was 5.1 years (range, 1.1 to 9.9 y). Acetabular remodeling was assessed on radiographs by the ADR. Changes in preoperative and postoperative ADR were analyzed using linear mixed-effects models. Patients were divided into 2 different groups for the postoperative ADR analysis: Gross Motor Function Classification System (GMFCS) levels I, II, and III compared with GMFCS levels IV and V. The progression of ADR versus age was determined in a set of 917 normal children (1834 hips) for comparison. RESULTS There was a statistically significant increase (improvement) in ADR postsurgically for the collective CP set (P |
| Databáze: | OpenAIRE |
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