RT Journal
A1 Bielski, Robert J.
T1 Soft-Tissue Release for Hip Subluxation in Cerebral Palsy: What Is the Role in the Nonambulatory Patient?Commentary on an article by Benjamin J. Shore, MD, FRCSC, et al.: “Adductor Surgery to Prevent Hip Displacement in Children with Cerebral Palsy: The Predictive Role of the Gross Motor Function Classification System”
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2012
FD February 15
VO 94
IS 4
SP e27 1
OP 2
DO 10.2106/JBJS.K.01517
UL http://dx.doi.org/10.2106/JBJS.K.01517
AB 
In this Level-II study, the authors present a very large series of patients with hip subluxation due to cerebral palsy who were treated with soft-tissue releases. The surgery consisted of adductor lengthening, often combined with iliopsoas lengthening and phenol injection around the anterior branch of the obturator nerve. The authors defined failure of the treatment as either the need for further surgery or progression of the migration percentage beyond 50%. In 330 patients with a mean follow-up of 7.1 years, the Gross Motor Function Classification System (GMFCS) and the initial migration percentage were the best predictors of long-term success or failure. Their results are sobering: in the 242 patients who were classified as GMFCS level IV or V, the success rates were only 27% and 14%, respectively.