Selective control assessment of the lower extremity (SCALE) score correlates with joint‐specific gait deviations in children with bilateral cerebral palsy

(150 hips; mean age 8y7mo; 68 males, 42 females) who underwent hip reconstructive surgeries including Dega pelvic osteotomy using iliac crest allograft. Materials/Methods: To evaluate the time of allograft incorporation, Goldberg score was measured according to the follow-up period on all serial postoperative radiographs. Radiographic delayed union was defined as a Goldberg score <6 by 6 months after the surgery. The acetabular index, migration percentage, and neck-shaft angle were also measured on the preoperative and postoperative follow-up radiographs. Results: All radiographic indices were significantly improved after hip reconstructive surgery including the Dega osteotomy (all p<0.001). AI was not changed at final follow-up (p=1.000), but MP and NSA had significantly increased at final follow-up (both p<0.001). The mean estimated time for allograft incorporation (Goldberg score ≥6) was 1.1 years postoperatively. Twenty-four hips (16%, 4 hips with GMFCS level IV and 20 hips with GMFCS level V) were classified as radiographic delayed union (Goldberg score <6) at 6 months after surgery. Nine hips (6%, all hips with GMFCS level V) had Goldberg score <6 at 1 year after surgery. However, all hips showed radiographic union at the final follow-ups and no hips underwent reoperation due to nonunion. There was no case of bone graft resorption, nonunion, dislodgement, and graft-related infections GMFCS level was significantly associated with radiographic delayed union (p=0.001). Patients with GMFCS level V had 6.9 times higher risks for radiographic delayed union than those with GMFCS level III and IV. Acetabular index did not increase during the follow-up period (p=0.316). Conclusions/Significance: Dega pelvic osteotomy using iliac crest allograft was effective in correcting acetabular dysplasia, without graft-related complications in patients with CP. Furthermore, the correction of acetabular dysplasia remained stable during the follow-up period. However, physicians should consider that allograft incorporation in patients with GMFCS level V can be delayed compared with those with GMFCS level III & IV.