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Hip displacement and dislocation in a total population of children with cerebral palsy in Scotland

Wordie, Sarah J. ; Robb, James E. ; Hägglund, Gunnar LU ; Bugler, Kate E. and Gaston, Mark S. (2020) In The Bone & Joint Journal 102-B(3). p.383-387
Abstract

AIMS: The purpose of this study was to compare the prevalence of hip displacement and dislocation in a total population of children with cerebral palsy (CP) in Scotland before and after the initiation of a hip surveillance programme. PATIENTS: A total of 2,155 children with CP are registered in the Cerebral Palsy Integrated Pathway Scotland (CPIPS) surveillance programme, which began in 2013. Physical examination and hip radiological data are collected according to nationally agreed protocols. METHODS: Age, Gross Motor Function Classification System (GMFCS) level, subtype of CP, migration percentage (MP), and details of hip surgery were analyzed for all children aged between two and 16 years taken from a time of census in March 2019 and... (More)

AIMS: The purpose of this study was to compare the prevalence of hip displacement and dislocation in a total population of children with cerebral palsy (CP) in Scotland before and after the initiation of a hip surveillance programme. PATIENTS: A total of 2,155 children with CP are registered in the Cerebral Palsy Integrated Pathway Scotland (CPIPS) surveillance programme, which began in 2013. Physical examination and hip radiological data are collected according to nationally agreed protocols. METHODS: Age, Gross Motor Function Classification System (GMFCS) level, subtype of CP, migration percentage (MP), and details of hip surgery were analyzed for all children aged between two and 16 years taken from a time of census in March 2019 and compared to the same data from the initial registration of children in the CPIPS. Displacement of the hip was defined as a MP of between 40% and 99%, and dislocation as a MP of 100%. RESULTS: A total of 1,646 children were available for analysis at the time of the census and 1,171 at their first registration in CPIPS. The distribution of age, sex, and GMFCS levels were similar in the two groups. The prevalence of displacement and dislocation of the hip before surveillance began were 10% (117/1,171) and 2.5% (29/1,171) respectively, and at the time of the census were 4.5% (74/1,646) and 1.3% (21/1,646), respectively. Dislocation was only seen in GMFCS levels IV and V and displacement seen in 90.5% (67/74) of these levels and 9.5% (7/74) in levels I to III. In total, 138 children had undergone hip surgery during the study period. The hip redisplaced after the initial surgery in 15 children; seven of these had undergone a second procedure and at the time of the census the hips in all seven had a MP < 40. CONCLUSION: Hip surveillance appears to be effective and has reduced the prevalence of hip displacement by over half and dislocation almost by half in these children. 

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cerebral palsy, Hip dislocation
in
The Bone & Joint Journal
volume
102-B
issue
3
pages
5 pages
publisher
British Editorial Society of Bone & Joint Surgery
external identifiers
  • pmid:32114804
  • scopus:85080840542
ISSN
2049-4408
DOI
10.1302/0301-620X.102B3.BJJ-2019-1203.R1
language
English
LU publication?
yes
id
5570e88b-888f-4408-8d9e-9300eeb94f19
date added to LUP
2020-03-18 13:42:54
date last changed
2021-04-06 04:32:01
@article{5570e88b-888f-4408-8d9e-9300eeb94f19,
  abstract     = {<p>AIMS: The purpose of this study was to compare the prevalence of hip displacement and dislocation in a total population of children with cerebral palsy (CP) in Scotland before and after the initiation of a hip surveillance programme. PATIENTS: A total of 2,155 children with CP are registered in the Cerebral Palsy Integrated Pathway Scotland (CPIPS) surveillance programme, which began in 2013. Physical examination and hip radiological data are collected according to nationally agreed protocols. METHODS: Age, Gross Motor Function Classification System (GMFCS) level, subtype of CP, migration percentage (MP), and details of hip surgery were analyzed for all children aged between two and 16 years taken from a time of census in March 2019 and compared to the same data from the initial registration of children in the CPIPS. Displacement of the hip was defined as a MP of between 40% and 99%, and dislocation as a MP of 100%. RESULTS: A total of 1,646 children were available for analysis at the time of the census and 1,171 at their first registration in CPIPS. The distribution of age, sex, and GMFCS levels were similar in the two groups. The prevalence of displacement and dislocation of the hip before surveillance began were 10% (117/1,171) and 2.5% (29/1,171) respectively, and at the time of the census were 4.5% (74/1,646) and 1.3% (21/1,646), respectively. Dislocation was only seen in GMFCS levels IV and V and displacement seen in 90.5% (67/74) of these levels and 9.5% (7/74) in levels I to III. In total, 138 children had undergone hip surgery during the study period. The hip redisplaced after the initial surgery in 15 children; seven of these had undergone a second procedure and at the time of the census the hips in all seven had a MP &lt; 40. CONCLUSION: Hip surveillance appears to be effective and has reduced the prevalence of hip displacement by over half and dislocation almost by half in these children. </p>},
  author       = {Wordie, Sarah J. and Robb, James E. and Hägglund, Gunnar and Bugler, Kate E. and Gaston, Mark S.},
  issn         = {2049-4408},
  language     = {eng},
  number       = {3},
  pages        = {383--387},
  publisher    = {British Editorial Society of Bone & Joint Surgery},
  series       = {The Bone & Joint Journal},
  title        = {Hip displacement and dislocation in a total population of children with cerebral palsy in Scotland},
  url          = {http://dx.doi.org/10.1302/0301-620X.102B3.BJJ-2019-1203.R1},
  doi          = {10.1302/0301-620X.102B3.BJJ-2019-1203.R1},
  volume       = {102-B},
  year         = {2020},
}