Long-term changes in femoral anteversion and hip rotation following femoral derotational osteotomy in children with cerebral palsy

Elizabeth Boyer, Tom F. Novacheck, Adam Rozumalski, Michael H. Schwartz

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Background Excessive femoral anteversion is common in cerebral palsy (CP), is often associated with internal hip rotation during gait, and is frequently treated with a femoral derotational osteotomy (FDO). Concerns exist regarding long-term maintenance of surgical outcomes. Past studies report varying rates of recurrence, but none have employed a control group. Methods We conducted a retrospective analysis examining long-term (∼5 years) changes in anteversion and hip rotation following FDO in children with CP. We included a control group that was matched for age and exhibited excessive anteversion (>30°) but did not undergo an FDO. Anteversion, mean stance hip rotation, and rates of problematic remodeling and recurrence were assessed (>15° change and final level outside of normal limits). Results The control group was reasonably well matched, but exhibited 9° less anteversion and 3° less internal hip rotation at the pre time point. At a five year follow-up, the FDO group had less anteversion than the control group (20° vs. 35°, p < 0.05). The mean stance phase hip rotation did not differ between the groups (4° vs. 5°, p = 0.17). Over one third of limbs remained excessively internal in both groups (FDO: 34%, Control: 37%). Rates of problematic recurrence and remodeling were low (0%–11%). Conclusions An FDO is an effective way to correct anteversion in children with CP. Long-term hip rotation is not fully corrected by the procedure, and is not superior to a reasonably well matched control group. Rates of problematic recurrence and remodeling are low, and do not differ between the groups.

Original languageEnglish (US)
Pages (from-to)223-228
Number of pages6
JournalGait and Posture
Volume50
DOIs
StatePublished - Oct 1 2016

Keywords

  • Cerebral palsy
  • Femoral derotational osteotomy
  • Gait analysis
  • Outcome
  • Recurrence
  • Torsion

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