Department of Orthopaedic Surgery, Sint Maartenskliniek, Hengstdal 3, PO Box 9011, 6500, GM, Nijmegen, The Netherlands.
Arch Orthop Trauma Surg. 2013 Jul;133(7):1011-6. doi: 10.1007/s00402-013-1759-9. Epub 2013 Apr 30.
Total hip arthroplasty (THA) is one of the treatment options in patients with cerebral palsy (CP) with painful osteoarthritis of the hip. However, the risk of dislocation of the prosthesis is higher in patients with CP when compared with physically normal patients. In this retrospective study of ten consecutive cases, we hypothesized that the use of a dual-mobility cup could reduce this risk of dislocation combined with good functional results.
From January 2008 until October 2010, eight patients (ten hips) with CP who consecutively received a THA using a dual-mobility cup were identified. At the time of surgery, the average age of the patient group was 54 years (range 43-61). Latest follow-up took place after on average 39 months (range 22-56 months). All patients or their caregivers were interviewed by telephone. They were asked if dislocation of the prosthesis had occurred. To evaluate quality of life and health in general, patients completed the SF-36 questionnaire.
None of the prostheses had dislocated at the latest follow-up. Reoperation was needed in one patient after a periprosthetic fracture. Radiologic evaluation showed a mean cup inclination of 46 (range 27-58). On average, the quality of life of patients in this study was found to be limited in particular on the domains of physical health and functioning, while a fair to good score was measured at the six other different domains.
The use of a dual-mobility cup in THA in patients with CP can lead to favourable results with respect to dislocation and clinical outcome.
全髋关节置换术（THA）是脑瘫（CP）合并髋关节骨关节炎疼痛患者的治疗选择之一。然而，与体格正常的患者相比，CP 患者假体脱位的风险更高。在这项连续十例的回顾性研究中，我们假设使用双动杯可以降低这种脱位风险，同时获得良好的功能结果。
从 2008 年 1 月至 2010 年 10 月，连续接受双动杯 THA 的 8 例 CP 患者（10 髋）被确定。手术时，患者组的平均年龄为 54 岁（范围 43-61 岁）。平均随访时间为 39 个月（范围 22-56 个月）。所有患者或其照顾者均通过电话进行访谈。询问他们是否发生了假体脱位。为了评估生活质量和总体健康状况，患者完成了 SF-36 问卷。
在最新随访时，没有假体脱位。1 例患者发生假体周围骨折后需要再次手术。放射学评估显示平均杯倾斜度为 46°（范围 27-58°）。平均而言，本研究中患者的生活质量在身体健康和功能方面受到限制，而在其他六个不同领域则测量到了良好到较好的评分。
CP 患者 THA 中使用双动杯可以在脱位和临床结果方面取得良好的效果。
