Soft tissue surgery as an initial treatment for hip displacement in spastic cerebral palsy

Objective : To use the measurement of migration percentage (MP) to evaluate the long-term radiographic results of soft tissue surgery as the first treatment for hip displacement in spastic bilateral cerebral palsy. A secondary objective was to identify predictive factors of stability (i.e., less than 30% of MP in the long term), after surgical correction. Methods : In this longitudinal cohort study, we reviewed the electronic medical records and radiographs of all consecutive patients with cerebral palsy operated for the correction of hip displacement between 1984 and 2013 in a referral orthopedic public hospital in Brazil. Patients were included if they had received, as the first surgical procedure, soft-tissue release. All surgeries were bilateral and symmetrical. We used the available radiographs to evaluate the migration percentage (MP), acetabular index (AI), pelvic obliquity (PO) angle, head-shaft angle (HSA), congruence and femoral head sphericity, and function using the GMFCS (Gross Motor Function Classification System). Results : we included 93 patients, all operated before being 12 years old, with follow-up of 10 years in average, 73 (78%) of them with good results (MP