Hip dislocation in patients with spinal muscular atrophy.

The propensity for hip dislocation in patients with spinal muscular atrophy (SMA) is well documented, but the appropriate treatment and even the long-term outcome of these hips in this patient population have not been well defined. The purpose of this study was to determine by long-term follow-up the natural history of dislocated hips in a cohort of SMA patients from a single institution. Pain and functional difficulties (positioning, skin and perineal care) were assessed and radiographs were reviewed in a total of 41 patients with a mean of 18 years of follow-up. Seventeen of 82 hips (21%) were dislocated in 14 patients and 20 hips were subluxed. Only two patients had any hip pain at follow-up, one had difficulty with seating, and no patients had difficulty with perineal care. Given the small number of patients with symptoms with dislocated hips, observation rather than surgical intervention seems warranted in SMA patients with hip dislocation.