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Article

Guarded Outcomes After Hip Hemiarthroplasty in Patients with Cerebral Palsy: Highlighting a Personalized Medicine Approach to Mitigate the Risk of Complications

1
Geisinger Musculoskeletal Institute, Geisinger Medical Center, Danville, PA 17822, USA
2
Orthopedic Surgery Department, Faculty of Medicine, Ain Shams University, Cairo 11591, Egypt
*
Authors to whom correspondence should be addressed.
J. Pers. Med. 2025, 15(6), 252; https://doi.org/10.3390/jpm15060252
Submission received: 7 April 2025 / Revised: 5 June 2025 / Accepted: 7 June 2025 / Published: 15 June 2025

Abstract

Background: The effectiveness of hip hemiarthroplasty in managing femoral neck fractures in individuals with cerebral palsy has seldom been reported. Objectives: Given the complex neuromuscular issues associated with cerebral palsy (CP), this retrospective study aims to document the outcomes and characterize the complications of hip hemiarthroplasty for fractures of the femoral neck in a series of patients with CP, emphasizing the role of precision medicine in management. Methods: Six cases of hip hemiarthroplasty in six male patients with cerebral palsy and displaced femoral neck fractures have been reviewed in this study. The patients’ mean age at the time of surgery was 55.6 ± 14.1 years (range, 33–71). All the patients were independent indoor ambulators before their femoral neck fracture and had various medical comorbidities. Five patients had intellectual disabilities. Results: The mean clinical and radiographic follow-ups for the patients included in this series were 91.5 and 71.3 months, respectively. All the patients developed significant heterotopic ossification (HO) around the operated hip, which was observed as early as the second week postoperatively on radiographs. HO progressed throughout the follow-up for all the patients. One patient had an early postoperative dislocation with femoral stem loosening, which was managed by implant revision. Another patient had an acetabular protrusion, leading to the loss of their weight-bearing ability and mobility due to pain. Four patients were deceased at a mean of 86.5 months after the index surgery. Conclusions: After considering the preliminary evidence provided with this small case series, this study suggests the overall guarded outcomes of hip hemiarthroplasty in patients with CP. Given the 100% rate of heterotopic ossification, a precision medicine framework with consideration for HO prophylaxis may be recommended after hip hemiarthroplasty in patients with CP. It may also be reasonable to scrutinize a personalized risk assessment approach in this patient subset regarding decision making, surgical approach, and rehabilitation program. The clinical outcomes and the risks of complications following hemiarthroplasty should be sensibly presented to patients with cerebral palsy and their caregivers to achieve reasonable postoperative expectations.
Keywords: cerebral palsy; fracture; femoral neck; hip hemiarthroplasty; heterotopic ossification cerebral palsy; fracture; femoral neck; hip hemiarthroplasty; heterotopic ossification

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MDPI and ACS Style

Mahmoud, A.N.; Brule, N.R.; Bernate, J.D.; Seeley, M.A.; Suk, M.; Horwitz, D.S. Guarded Outcomes After Hip Hemiarthroplasty in Patients with Cerebral Palsy: Highlighting a Personalized Medicine Approach to Mitigate the Risk of Complications. J. Pers. Med. 2025, 15, 252. https://doi.org/10.3390/jpm15060252

AMA Style

Mahmoud AN, Brule NR, Bernate JD, Seeley MA, Suk M, Horwitz DS. Guarded Outcomes After Hip Hemiarthroplasty in Patients with Cerebral Palsy: Highlighting a Personalized Medicine Approach to Mitigate the Risk of Complications. Journal of Personalized Medicine. 2025; 15(6):252. https://doi.org/10.3390/jpm15060252

Chicago/Turabian Style

Mahmoud, Ahmed Nageeb, Nicholas R. Brule, Juan D. Bernate, Mark A. Seeley, Michael Suk, and Daniel S. Horwitz. 2025. "Guarded Outcomes After Hip Hemiarthroplasty in Patients with Cerebral Palsy: Highlighting a Personalized Medicine Approach to Mitigate the Risk of Complications" Journal of Personalized Medicine 15, no. 6: 252. https://doi.org/10.3390/jpm15060252

APA Style

Mahmoud, A. N., Brule, N. R., Bernate, J. D., Seeley, M. A., Suk, M., & Horwitz, D. S. (2025). Guarded Outcomes After Hip Hemiarthroplasty in Patients with Cerebral Palsy: Highlighting a Personalized Medicine Approach to Mitigate the Risk of Complications. Journal of Personalized Medicine, 15(6), 252. https://doi.org/10.3390/jpm15060252

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