Neuromuscular

Cerebral Palsy

 

Issues

- spasticity / joint contractures

- hip subluxation /dislocation preoperatively

- dysplastic femoral head / acetabulum

 

Cerebral palsyCP hip

 

Results

 

O'Driscoll et al Arthroplasty Today 2022

- systematic review of 7 studies and 189 patients

- mild and severe CP

- mean 8 years follow up

- dislocation 11%, aseptic loosening 6%, infection 3%, fractures 3%

 

Down's Syndrome

 

Issues

- ligamentous laxity

- acetabular dysplasia

 

Results

 

Kosashvili et al J Arthroplasty Orthopedics 2010

- 9 THA for Down's syndrome

- 6 had DDH, 1 with SCFE

- 6/9 required constrained liners

 

Parkinson's disease

 

Issues

- increased tone / rigidity / tremors

- dementia

 

Results

 

Jamsen et al Bone Joint J 2014

- Parkinson's versus controls

- increased risk hip dislocation first year

- 65% 10 year mortality for Parkinson's patients