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Hip displacement in relation to age and gross motor function in children with cerebral palsy

Larnert, Per ; Risto, Olof ; Hägglund, Gunnar LU and Wagner, Philippe LU (2014) In Journal of Children's Orthopaedics 8(2). p.129-134
Abstract

Purpose: Hip dislocation in cerebral palsy (CP) is a serious complication. By radiographic screening and prophylactic surgery of children at risk most dislocations can be prevented. CPUP, the Swedish CP registry and follow-up program, includes annual radiographic examinations of children at Gross Motor Function Classification System (GMFCS) levels III-V. Data from CPUP were analysed to assess the risk of hip displacement in relation to GMFCS levels and age. Methods: All children at GMFCS levels III-V (N = 353) whose first radiographic screening occurred before 3 years of age were followed between the ages 2-7 years. Migration percentages (MPs) were recorded annually (1,664 pelvic radiographs) and analysed using discrete time survival... (More)

Purpose: Hip dislocation in cerebral palsy (CP) is a serious complication. By radiographic screening and prophylactic surgery of children at risk most dislocations can be prevented. CPUP, the Swedish CP registry and follow-up program, includes annual radiographic examinations of children at Gross Motor Function Classification System (GMFCS) levels III-V. Data from CPUP were analysed to assess the risk of hip displacement in relation to GMFCS levels and age. Methods: All children at GMFCS levels III-V (N = 353) whose first radiographic screening occurred before 3 years of age were followed between the ages 2-7 years. Migration percentages (MPs) were recorded annually (1,664 pelvic radiographs) and analysed using discrete time survival analysis. Results: The risk of hip displacement between 2 years and 7 years of age was significantly (p < 0.05) higher for children at GMFCS level V during the entire study period. The risk was highest at 2-3 years of age and decreased significantly (p < 0.001) with each year of age (OR = 0.71, 95 % CI 0.60-0.83). The cumulative risk at age 7 years for those at GMFCS V for MP ≥ 40 % was 47 % (95 % CI 37-58). The corresponding risk at GMFCS IV was 24 % (16-34) and at GMFCS III 23 % (12-42). Conclusions: Children at GMFCS V have a significantly higher risk of hip displacement compared with children at GMFCS III-IV. The risk is highest at 2-3 years of age. The results support a surveillance program including radiographic hip examinations as soon as the diagnosis of severe CP is suspected.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cerebral palsy, CP, Hip dislocation, Hip displacement, Hip surveillance
in
Journal of Children's Orthopaedics
volume
8
issue
2
pages
6 pages
publisher
Springer
external identifiers
  • scopus:84897432106
ISSN
1863-2521
DOI
10.1007/s11832-014-0570-7
language
English
LU publication?
yes
id
2d021397-a178-454a-87d5-21838fc0e57d
date added to LUP
2019-06-25 10:06:11
date last changed
2022-03-10 18:03:56
@article{2d021397-a178-454a-87d5-21838fc0e57d,
  abstract     = {{<p>Purpose: Hip dislocation in cerebral palsy (CP) is a serious complication. By radiographic screening and prophylactic surgery of children at risk most dislocations can be prevented. CPUP, the Swedish CP registry and follow-up program, includes annual radiographic examinations of children at Gross Motor Function Classification System (GMFCS) levels III-V. Data from CPUP were analysed to assess the risk of hip displacement in relation to GMFCS levels and age. Methods: All children at GMFCS levels III-V (N = 353) whose first radiographic screening occurred before 3 years of age were followed between the ages 2-7 years. Migration percentages (MPs) were recorded annually (1,664 pelvic radiographs) and analysed using discrete time survival analysis. Results: The risk of hip displacement between 2 years and 7 years of age was significantly (p &lt; 0.05) higher for children at GMFCS level V during the entire study period. The risk was highest at 2-3 years of age and decreased significantly (p &lt; 0.001) with each year of age (OR = 0.71, 95 % CI 0.60-0.83). The cumulative risk at age 7 years for those at GMFCS V for MP ≥ 40 % was 47 % (95 % CI 37-58). The corresponding risk at GMFCS IV was 24 % (16-34) and at GMFCS III 23 % (12-42). Conclusions: Children at GMFCS V have a significantly higher risk of hip displacement compared with children at GMFCS III-IV. The risk is highest at 2-3 years of age. The results support a surveillance program including radiographic hip examinations as soon as the diagnosis of severe CP is suspected.</p>}},
  author       = {{Larnert, Per and Risto, Olof and Hägglund, Gunnar and Wagner, Philippe}},
  issn         = {{1863-2521}},
  keywords     = {{Cerebral palsy; CP; Hip dislocation; Hip displacement; Hip surveillance}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{2}},
  pages        = {{129--134}},
  publisher    = {{Springer}},
  series       = {{Journal of Children's Orthopaedics}},
  title        = {{Hip displacement in relation to age and gross motor function in children with cerebral palsy}},
  url          = {{http://dx.doi.org/10.1007/s11832-014-0570-7}},
  doi          = {{10.1007/s11832-014-0570-7}},
  volume       = {{8}},
  year         = {{2014}},
}