Categories
Decreased tone
- Polio
- Down's syndrome
- spina bifida
Increased tone
- cerbral palsy
- Parkinson's
- CVA
Polio
Rare
- case reports only
Down's Syndrome
Acetabular dysplasia not uncommon in this group
Results
Kloschos et al JBJS Br 2002
- 6 patients
- 7 year follow up
- all doing well
Cerebral Palsy
Options
- THR
- resection arthroplasty
- pelvic support osteotomy
- arthrodesis
THR offers best pain relief and function
Problems
Young patient
- abnormal muscle strength
- spasticity and contractures
- co-operation issues
- functional demand is low
Results
Schroeder et al Int Orthop 2010
- 18 THR in ambulatory patients
- 10 year follow up
- 1 recurrent dislocation
- 3 aseptic loosenings
Parkinson's disease
Issues
- poor neurological status
- progressive worsening with dementia
- high risk dislocation
Results
Weber Int Orthop 2002
- no dislocations in 58 primary THR for Parkinson's
Osteogenesis Imperfecta
