Risk Factors for Avascular Necrosis in Children With Cerebral Palsy Following Varus Derotation Osteotomy.

This is the largest analysis of AVN in children with CP who underwent VDRO. PO was a significant risk factor for developing AVN after VDRO. Although the overall incidence is low, the increased odds of AVN in patients undergoing POs is a factor surgeons should consider when undertaking surgery for children with CP and displaced hips. The association with PO may explain why several factors were significant solely in univariate analysis. For example, children functioning at GMFCS level V underwent ~3.5 times the rate of POs than their higher-functioning peers (29.0% vs. 8.2%, P<0.01). Finally, the Rutz and MCPHCS classifications suggest that AVN may not significantly impact postoperative hip sphericity. In combination with the low incidence of AVN, these findings indicate that rather than focusing solely on AVN risk, sphericity preservation may be more critical for optimal health outcomes in children with CP.