Adductor tenotomies in children with quadriplegic cerebral palsy: longer term follow-up.

Adductor tenotomy procedures for prophylaxis against severe hip subluxation in children with quadriplegic cerebral palsy have reported good to excellent success rates; however, the overall follow-up has been short. In a retrospective review designed to obtain longer term follow-up of adductor tenotomies in these children, we found that 58% of our patients had continued subluxation or dislocation with the eventual need for further surgery. These results differ significantly from those of previous studies. There was a trend among the patients who did well to have less preoperative subluxation than those who needed further intervention, but we did not find a statistically significant cut-off value that was predictive of success or failure. Age at the time of surgery also did not influence the outcome in our patient population. An 8-year average follow-up of adductor tenotomies showed a higher loss of hip stability than previous mid range follow-up studies.