Managing Pain in Cerebral Palsy Patients Using Ethanol Hip Joint Injection: A Retrospective Chart Review

Area of Science:

• Orthopedics
• Pain Management
• Regenerative Medicine

Background:

• Cerebral palsy (CP) patients with severe hip dysplasia often face limited treatment options beyond invasive surgery.
• Nonoperative management strategies for hip pain in this population are not extensively studied.
• Ethanol hip joint injection presents a potential less invasive alternative for pain relief.

Purpose of the Study:

• To evaluate the effectiveness of ethanol hip joint injections in alleviating hip pain for patients with CP and severe hip dysplasia.
• To assess the outcomes and duration of pain control following ethanol injections.
• To determine the need for repeat injections and identify any adverse events.

Main Methods:

• A study involving 57 patients (71 hips) with moderate-to-severe or severe hip pain due to CP (GMFCS level 4 or 5).
• 104 total injections of 10-15 mL of 75% ethanol administered under general anesthesia and C-arm guidance.
• Pain was assessed on a 1-5 scale, with a reduction to below 4 considered clinical success; Kaplan-Meier analysis was used for time-to-event evaluation.

Main Results:

• 86% (61 of 71 hips) achieved pain reduction to below 4 after the first ethanol injection.
• Median time to pain control was four months, with 85% experiencing relief within 10 months.
• 31% required a second injection after a median of 33 months; 36% experienced pain relapse overall.

Conclusions:

• Ethanol hip joint injection is a promising, less invasive treatment for hip pain in CP patients with severe dysplasia.
• The procedure provided significant pain control in a majority of patients, with sustained relief in many.
• Further research into ethanol injection as a therapeutic modality for this patient group is warranted.