Three-Year Outcomes Following Hip Reconstruction in Cerebral Palsy: A Population-Based Analysis

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Reconstructive Surgery

Background:

• Pelvic reconstruction is a common procedure for hip displacement in cerebral palsy (CP).
• Existing outcome data are limited and often from single centers, lacking generalizability.
• This study provides national outcome data for hip reconstruction in CP patients.

Purpose of the Study:

• To describe the population-based outcomes of hip reconstruction in patients with cerebral palsy (CP).
• To analyze the incidence and timing of key postoperative events.
• To inform future surveillance and prevention strategies.

Main Methods:

• Retrospective cohort study using the TriNetX Research Network (163 million patients, 117 organizations).
• Included patients aged 1-25 years with CP undergoing hip reconstruction (2015-2022).
• Assessed hardware removal, hip dislocation, infection, and mortality using Kaplan-Meier analysis (6 months to 3 years postoperatively).

Main Results:

• Among 1037 patients, 3-year cumulative incidence: 38.6% hardware removal, 38.5% hip dislocation, 3.6% infection, 2.6% mortality.
• Hip dislocation predominantly occurred early (61% in year 1).
• Hardware removal was late-predominant (70% in years 2-3), and 83% of infections presented after the first postoperative year.

Conclusions:

• Hip reconstruction in CP patients is associated with high rates of hardware removal and dislocation.
• A significant proportion of hardware-associated infections manifest after the first postoperative year.
• Long-term hip surveillance is recommended, and prospective studies are needed to refine prevention strategies.