Related Experiment Video
Updated: Jan 23, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Total Joint Arthroplasty in Patients With Cerebral Palsy
Andrew S Moon1, Martim C Pinto, Kyle H Cichos
1From the Department of Orthopaedic Surgery, University of Alabama at Birmingham Hospital, Birmingham, AL.
Insights
Patients with cerebral palsy (CP) face higher risks of perioperative complications after total joint arthroplasty (TJA), particularly anemia. However, TJA can be successful with careful planning and management for CP patients.
Area of Science:
- Orthopedic Surgery
- Rehabilitative Medicine
- Public Health
Background:
- Cerebral palsy (CP) frequently leads to joint arthrosis, necessitating total hip (THA) and knee arthroplasty (TKA).
- Understanding perioperative risks in CP patients undergoing THA and TKA is crucial for optimizing outcomes.
Purpose of the Study:
- To compare in-hospital characteristics and comorbidities between CP and non-CP patients undergoing total joint arthroplasty (TJA).
- To assess the risk of perioperative complications in CP patients following TJA.
Main Methods:
- Retrospective cohort study utilizing the Nationwide Inpatient Sample database (2005-2014).
- Comparison of demographics, comorbidities, hospital characteristics, perioperative complications, and length of stay between CP and non-CP patients undergoing TJA.
- Statistical analysis using Rao-Scott chi-square test and analysis of variance, accounting for study weighting.
Main Results:
- CP patients undergoing THA and TKA were younger and had longer hospital stays but lower comorbidity indices (THA) or similar profiles (TKA) compared to non-CP patients.
- Non-CP patients exhibited higher rates of obesity, coronary artery disease, diabetes, and peripheral vascular disease.
- CP patients demonstrated a significantly higher risk of overall and surgical postoperative complications, notably acute postoperative anemia.
Conclusions:
- Younger CP patients with fewer comorbidities experience increased perioperative complications after TJA.
- Successful TJA outcomes are achievable in CP patients through meticulous medical management and surgical planning.
- CP patients require specialized perioperative care to mitigate risks associated with TJA.
Introduction:
Cerebral palsy (CP) is a neurodevelopmental condition with a wide range of presentations that usually lead to muscle imbalance culminating with precocious knee and hip arthrosis, often leading to total hip (THA) and knee arthroplasty (TKA). This study sought to determine the following: (1) the inherent differences of in-hospital characteristics and comorbidities between CP and non-CP patients undergoing total joint arthroplasty (TJA) and (2) do patients with CP have an increased risk of perioperative complications after TJA?
Methods:
The Nationwide Inpatient Sample database from 2005 to 2014 was queried in this retrospective cohort study to compare patient demographics and comorbidities, hospital characteristics, perioperative complications, and length of stay in patients with CP undergoing TJA compared with their non-CP counterparts. Statistical analyses were performed using the Rao-Scott chi-square test and analysis of variance. All analyses took into account the sampling procedure and weighting.
Results:
A total of 2,062 and 2,193 patients with CP underwent THA and TKA, respectively, during the study period. Both CP groups were younger (P < 0.0001), were more likely to have Medicaid insurance (P < 0.0001), and had longer lengths of hospital stay (P < 0.0001) compared with their non-CP counterparts. Non-CP patients had significantly higher rates of obesity, coronary artery disease, diabetes, and peripheral vascular disease (P < 0.05). However, patients with CP undergoing THA had a lower Charlson Comorbidity Index (P = 0.0002), whereas those undergoing TKA had similar comorbidity profile as the non-CP group (P = 0.097). Both THA and TKA CP patients had a higher risk of overall postoperative complications (P < 0.05) and surgical complications (P < 0.05), in particular acute postoperative anemia (P < 0.05).
Conclusion:
Despite being younger with fewer comorbidities, patients with CP are at an increased risk of immediate perioperative complications after TJA compared with the general osteoarthritis population. Given that these patients have satisfactory long-term outcomes after TJA, these procedures can be performed successfully for patients with CP with careful medical management and surgical planning.
Level Of Evidence:
Level III, retrospective cohort study.
Related Concept Videos
01:16Structural Joints: Synovial Joints
01:03Structural Joints: Fibrous Joints
Suture
All the bones of the skull, except for the mandible, are joined to each other by a fibrous joint called a suture. The fibrous connective tissue found at a suture strongly unites the adjacent skull bones and thus helps to protect the brain and form the face. In...
01:17Structural Joints: Cartilaginous Joints
There are two types of cartilaginous joints:
Synchondrosis
A synchondrosis ("joined by cartilage") is a cartilaginous joint where bones are connected by hyaline cartilage. Synchondrosis may be temporary...
01:26Joints
Structural joint classifications are based on the material that makes up the joint as well as whether or not the joint contains a space between the bones. Joints are structurally classified as fibrous, cartilaginous, or synovial.
Fibrous Joints Are Immovable
The bones of a...
00:58Introduction to Joints
01:10Ankle Joint