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Rehabilitation after femoral osteotomy in cerebral palsy
Peter J Stasikelis1, Jon R Davids, Beverly H Johnson
1The Shriners Hospitals for Children, Greenville, South Carolina 29605, USA. pstasikelis@shrinenet.org
Insights
Children with cerebral palsy often need proximal femoral osteotomy. Most return to preoperative ambulatory function within 30 months, with community ambulators recovering in about 7 months.
Area of Science:
- Pediatric Orthopedics
- Cerebral Palsy Research
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) frequently causes hip instability, necessitating surgical intervention.
- Proximal femoral osteotomy is a common procedure to address hip instability in children with CP.
- Understanding recovery timelines is crucial for patient and family management.
Purpose of the Study:
- To determine the time to return to preoperative functional levels after proximal femoral osteotomy in children with cerebral palsy.
- To identify factors influencing the recovery duration.
Main Methods:
- Retrospective review of 71 children with CP who underwent proximal femoral osteotomy.
- Analysis of return to preoperative ambulatory function.
- Comparison of recovery times based on ambulatory status and therapy type.
Main Results:
- All 71 children returned to preoperative ambulatory function within 30 months.
- Community/household ambulators returned to function at a mean of 7 months.
- Wheelchair/therapeutic ambulators required a mean of 10 months.
- Children receiving regular licensed therapist visits showed faster recovery than those with parent-led exercises.
Conclusions:
- Rehabilitation after proximal femoral osteotomy in children with CP typically requires 7-10 months.
- Recovery can extend up to 30 months, emphasizing the need for individualized expectations.
- Regular professional therapy is associated with improved functional recovery rates.
Abstract:
This is a study of the time required to return to preoperative functional levels after proximal femoral osteotomy in children with cerebral palsy. Seventy-one consecutive children who underwent proximal femoral osteotomy to treat an unstable hip secondary to cerebral palsy are retrospectively reviewed. All children returned to their preoperative ambulatory function within 30 months of the procedure. Children who were community or household ambulators returned to their preoperative function at a mean of 7 months after osteotomy, while wheelchair and therapeutic ambulators required a mean of 10 months. Children who had regular visits with a licensed therapist tended to return to function more quickly than those who had exercises preformed by their parents or care-takers after instruction by a therapist. The authors conclude that families should be advised that rehabilitation after osteotomy requires on average 7-10 months, but times up to 30 months are possible.