Outcomes of total hip arthroplasty are just as good in patients with cerebral palsy (CP) as in patients with uncomplicated osteoarthritis (OA), new research shows.

“This study refutes previous evidence showing increased risk of complications following total hip arthroplasty in patients with cerebral palsy,” Dr. Matthew Houdek and colleagues from the Mayo Clinic in Rochester, Minnesota state. “Total hip arthroplasty is a durable treatment option and provides clinically important pain relief and functional improvement in patients with cerebral palsy.”

CP patients can develop hip degeneration and subluxation due to spasticity and increased muscle tone, Dr. Houdek and his team write in The Journal of Bone and Joint Surgery, in a paper released online March 17. Use of hip replacement in these patients is controversial due to concerns about complications, they add, but recent studies have found good long–term outcomes. The researchers matched 39 patients with CP who underwent total hip arthroplasty at their center over a 24–year period 1:2 with patients who had hip replacement for OA. Mean age in the CP group was 49 years.

Reoperation rates, implant survival, and complications, including dislocation, were similar for the CP and OA groups. All of the patients had severe or moderate pain before surgery, and after surgery no patients had severe to moderate pain. Ability to walk independently improved in 23 patients. Functional Harris hip scores also improved significantly.

Patients with cerebral palsy “should expect a similar outcome in terms of implant survival and postoperative complications compared with patients with a diagnosis of primary osteoarthritis,” Dr. Houdek and his colleagues state. “Currently, we consider total hip arthroplasty in patients with cerebral palsy who have clinical and radiographic findings that would warrant a total hip arthroplasty, are able to walk either independently or with the use of gait aids, and are willing to take on the potential risks and complications of a surgical procedure.”

Dr. Houdek was not available for an interview by press time.