Range of hip abduction after preventive and reconstructive surgery in cerebral palsy: a longitudinal registry study of 307 children

Background and purpose — Hip dislocation in cerebral palsy (CP) is caused by altered muscle forces on the joint during typical hip positioning in adduction–flexion–inward rotation. Preventive surgery includes adductor–psoas lengthening (APL) or varus derotation osteotomy (VDRO) of the proximal femur...

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Autores principales:	Gunnar Hägglund, Philippe Wagner
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2021
Materias:	Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/e05cb6f6dc574bab8eca8bdb27f2950a
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spelling	oai:doaj.org-article:e05cb6f6dc574bab8eca8bdb27f2950a2021-11-04T15:00:42ZRange of hip abduction after preventive and reconstructive surgery in cerebral palsy: a longitudinal registry study of 307 children1745-36741745-368210.1080/17453674.2021.1995813https://doaj.org/article/e05cb6f6dc574bab8eca8bdb27f2950a2021-10-01T00:00:00Zhttp://dx.doi.org/10.1080/17453674.2021.1995813https://doaj.org/toc/1745-3674https://doaj.org/toc/1745-3682Background and purpose — Hip dislocation in cerebral palsy (CP) is caused by altered muscle forces on the joint during typical hip positioning in adduction–flexion–inward rotation. Preventive surgery includes adductor–psoas lengthening (APL) or varus derotation osteotomy (VDRO) of the proximal femur. We assessed the changes in the hip abduction range after these operations. Patients and methods — Data were obtained from the Swedish Surveillance Programme for CP. The range of hip abduction before and up to 18–36 months after surgery was assessed for all children who underwent APL or VDRO. Data for 1 hip per child was assessed. Ordinary linear regression was used. Results — In the 150 children who underwent APL, the mean range of abduction increased from 29° (95% confidence interval [CI] 28–32) preoperatively to 37° (CI 35–39) at 18–36 months. In the 157 children who underwent VDRO, the respective mean values were 30° (CI 29–32) and 29° (CI 28–31). The mean difference in preoperative abduction between sides was greater in children who underwent unilateral (9.4°, CI 7.8–11) than bilateral (5.5°, CI 3.4–7.6) VDRO. At 18–36 months postoperatively, the differences between sides were almost unchanged. Interpretation — The range of hip abduction increased after APL but remained unchanged after VDRO. This may explain the normal development of hip displacement after these operations. Differences in abduction between sides were not substantially affected by whether VDRO was performed uni- or bilaterally.Gunnar HägglundPhilippe WagnerTaylor & Francis GrouparticleOrthopedic surgeryRD701-811ENActa Orthopaedica, Vol 0, Iss 0, Pp 1-4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthopedic surgery RD701-811
spellingShingle	Orthopedic surgery RD701-811 Gunnar Hägglund Philippe Wagner Range of hip abduction after preventive and reconstructive surgery in cerebral palsy: a longitudinal registry study of 307 children
description	Background and purpose — Hip dislocation in cerebral palsy (CP) is caused by altered muscle forces on the joint during typical hip positioning in adduction–flexion–inward rotation. Preventive surgery includes adductor–psoas lengthening (APL) or varus derotation osteotomy (VDRO) of the proximal femur. We assessed the changes in the hip abduction range after these operations. Patients and methods — Data were obtained from the Swedish Surveillance Programme for CP. The range of hip abduction before and up to 18–36 months after surgery was assessed for all children who underwent APL or VDRO. Data for 1 hip per child was assessed. Ordinary linear regression was used. Results — In the 150 children who underwent APL, the mean range of abduction increased from 29° (95% confidence interval [CI] 28–32) preoperatively to 37° (CI 35–39) at 18–36 months. In the 157 children who underwent VDRO, the respective mean values were 30° (CI 29–32) and 29° (CI 28–31). The mean difference in preoperative abduction between sides was greater in children who underwent unilateral (9.4°, CI 7.8–11) than bilateral (5.5°, CI 3.4–7.6) VDRO. At 18–36 months postoperatively, the differences between sides were almost unchanged. Interpretation — The range of hip abduction increased after APL but remained unchanged after VDRO. This may explain the normal development of hip displacement after these operations. Differences in abduction between sides were not substantially affected by whether VDRO was performed uni- or bilaterally.
format	article
author	Gunnar Hägglund Philippe Wagner
author_facet	Gunnar Hägglund Philippe Wagner
author_sort	Gunnar Hägglund
title	Range of hip abduction after preventive and reconstructive surgery in cerebral palsy: a longitudinal registry study of 307 children
title_short	Range of hip abduction after preventive and reconstructive surgery in cerebral palsy: a longitudinal registry study of 307 children
title_full	Range of hip abduction after preventive and reconstructive surgery in cerebral palsy: a longitudinal registry study of 307 children
title_fullStr	Range of hip abduction after preventive and reconstructive surgery in cerebral palsy: a longitudinal registry study of 307 children
title_full_unstemmed	Range of hip abduction after preventive and reconstructive surgery in cerebral palsy: a longitudinal registry study of 307 children
title_sort	range of hip abduction after preventive and reconstructive surgery in cerebral palsy: a longitudinal registry study of 307 children
publisher	Taylor & Francis Group
publishDate	2021
url	https://doaj.org/article/e05cb6f6dc574bab8eca8bdb27f2950a
work_keys_str_mv	AT gunnarhagglund rangeofhipabductionafterpreventiveandreconstructivesurgeryincerebralpalsyalongitudinalregistrystudyof307children AT philippewagner rangeofhipabductionafterpreventiveandreconstructivesurgeryincerebralpalsyalongitudinalregistrystudyof307children
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Range of hip abduction after preventive and reconstructive surgery in cerebral palsy: a longitudinal registry study of 307 children

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