Systematic Review of Total Hip Arthroplasty Outcomes in Cerebral Palsy Patients and a Comparative Analysis with Rheumatoid Arthritis

Table 4

Summary of the functional outcomes of the selected studies.

Study, year	Number of patients	Functional outcomes:
Molenaers et al. [15], 2017	29	(i) Mean postoperative Harris Hip Score for 17 patients: 79 (range 56–97)
		(ii) Excellent outcomes observed in 13 patients
		(iii) Good outcomes achieved in 4 patients
		(iv) A total of 20 patients reported being good and very satisfied with the results
		(v) 5 patients expressed satisfaction with some limited pain
Houdek et al. [16], 2017	119 (CP: 41 vs. non-CP: 78)	(i) Preoperative pain: all 41 patients experienced moderate to severe pain, while postoperatively, none reported pain
		(ii) Hip flexion contracture of ≥ 15°: 9 patients had it before surgery, but none had it postop
		(iii) Ambulation status preop: 10% were independent, 70% used aids, and 20% did not use aids. Postoperatively, 54% were independent, 46% used aids, and none required aids
		(iv) Harris Hip Score (0–100): preop score was 36, while postop score improved to 78
Silverio et al. [17], 2016	12	(i) Overall outcomes: 7 hips rated as excellent/good, while 9 were rated as fair/poor
		(ii) Pain outcomes: 9 hips achieved excellent/good results, and 7 showed fair/good outcomes. The average pain reduction was 8.2/10 following PFIA
		(iii) Range of motion (ROM) outcomes: 9 hips had excellent/good ROM, and 7 hips had fair/poor ROM
Morin et al. [10], 2016	33	(i) Function: independent sitting improved from 5 patients (15%) preop to 6 (18%) postop
		(ii) Pain: permanent pain reduced from 16 patients before THR (40%) to none after THR. Pain while sitting decreased from 20 patients preop (50%) to 1 patient postop (2.5%), and pain during transfer decreased from 28 patients preop (70%) to none postop
		(iii) Range of motion: flexion exceeding 80 degrees increased from 19 patients before THR (47.5%) to 34 patients after THR (85%)
King et al. [18], 2016	426 202 (389 with CP)	(i) Oxford Hip Score (0–48):
		(a) CP group: 47 pairs, with 12 at preop and 34 at 6-month follow-up
		(b) Control group: 92,073 pairs, with 18 at preop and 41 at 6 months
		(ii) EQ-5D health scale (0–100):
		(a) CP group: 43 pairs, with a score of 60 preop and 70 at 6 months
		(b) Control group: 80,341 pairs, with a score of 70 preop and 80 at 6 months
Abousamra et al. [19], 2016	12	(i) Pain: preop pain rated at 9, postop pain reduced to 0
		(ii) Range of motion: no statistically significant changes observed
		(iii) Gait: no statistically significant changes detected
		(iv) Radiographic changes: femoral head deformity improved in 4 hips and remained the same in 8. In contrast, acetabular deformity improved in 11 hips and remained the same in just 1 hip
		(v) Top of form
Yoon et al. [20], 2015	5	(i) Mean leg length discrepancy improved from 4.3 cm (range, 1.2 to 8 cm)
		(ii) Pain: 3 patients experienced complete pain relief, while 2 patients saw a reduction in their preoperative pain
		(iii) Function: 3 patients were able to return to their GMFCS level prior to the onset of hip pain, and 2 patients regained their preoperative GMFCS levels
Prosser et al. [9], 2012	19	(i) 16 out of 18 hips (89%) were painfree after surgery
		(ii) GMFCS grade improved in six patients (32%) at the last follow-up
		(iii) Perineal access was enhanced in 11 out of 13 (85%) quadriplegic patients
Schoreder et al. [23], 2010	13	(i) Pain levels assessed using a numerical rating scale (NAS):
		(ii) No pain: 10 patients, grade 2 pain: 1 patient, grade 4 pain: 1 patient, grade 10 pain: 1 patient
		(iii) Mean pain decreased significantly from 8.4 preoperative to 1.1 postoperative ()
		(iv) Walking outcomes:
		(a) 5 patients no longer required walking aids after the operation
		(b) 2 patients who initially walked without walking aids needed walking sticks after the operation
Raphael et al. [8], 2010	56	(i) Pain outcomes:
		(a) 81% (48 out of 56 patients) experienced complete pain relief
		(b) All patients achieved a reduction in preoperative pain
		(c) Mean pain score decreased from 8/10 to 0.7 postoperatively
		(ii) Function outcomes:
		(a) 88% (52 out of 56 patients) returned to their original GMFCS (gross motor function classification system) level of function before the onset of hip pain
Abu-Rajab et al. [27], 2007	15	(i) Pain:
		(a) Preop: 20 out of 21 patients (95%) reported pain
		(b) Postop: 9 out of 21 patients still experienced pain
		(ii) Seating difficulties:
		(a) Preop: 12 out of 21 patients (57%) had seating difficulties
		(b) Postop: only 1 out of 21 patients had seating difficulties after the operation
Schorle et al. [28], 2006	16	(i) 13 patients were pain-free; 3 patients had minor residual symptoms; independent mobility was improved
Weber et al. [29], 1999	16	(i) 79% of the patients reported improvement in function
		(ii) 87% reported good/excellent pain relief
Gabos et al. [30], 1999	11	(i) Pain: complete pain relief in 10 patients out of 11
		(ii) Sitting tolerance: improved in 11/11 patients, 5 patients achieved unlimited sitting tolerance
Buly et al. [31], 1993	18 (19 THA)	(i) 17 of 18 patients (94%) had pain relief and improved function after THA
Root et al. [32], 1986	15 patients (15 THA)	(i) 10/15 patients were pain-free