The Journal of Bone and Joint Surgery (American). 2006;88:121-129.
doi:10.2106/JBJS.E.00071
© 2006 The Journal of Bone and Joint Surgery, Inc.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the exams for this article:
 CME 1: January, February, March 2006
Pediatrics Test 9: Spring 2006 (publication date May 15, 2006; expiration d...
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Soo, B.
Right arrow Articles by Graham, H. K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Soo, B.
Right arrow Articles by Graham, H. K.
Related Collections
Right arrow Pediatrics
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?

Hip Displacement in Cerebral Palsy

Brendan Soo, MBBS1, Jason J. Howard, MD, FRCS(C)1, Roslyn N. Boyd, PhD, MSc(Physiotherapy)1, Susan M. Reid, MClinEpi1, Anna Lanigan, RN1, Rory Wolfe, PhD2, Dinah Reddihough, MD, FRACP, FAFRM1 and H. Kerr Graham, MD, FRCS(Ed), FRACS1

1 Departments of Orthopaedic Surgery (B.S., J.J.H., R.N.B., and H.K.G.) and Child Development and Rehabilitation (S.M.R., A.L., and D.R.), Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia. E-mail address for H.K. Graham: kerr.graham{at}rch.org.au
2 Monash University, Alfred Hospital, Commercial Road, Prahran, Victoria 3004, Australia

Investigation performed at the Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Parkville, Victoria, Australia

In support of their research for or preparation of this manuscript, one or more of the authors received a Murdoch Children's Research Institute Theme Grant. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Hip displacement is considered to be common in children with cerebral palsy but the reported incidence and the proposed risk factors vary widely. Knowledge regarding its overall incidence and associated risk factors can facilitate treatment of these children.

Methods: An inception cohort was generated from the Victorian Cerebral Palsy Register for the birth years 1990 through 1992, inclusive, and multiple data sources pertaining to the cohort were reviewed during 2004. Gross motor function was assessed for each child and was graded according to the Gross Motor Function Classification System (GMFCS), which is a valid, reliable, five-level ordinal grading system. Hip displacement, defined as a migration percentage of >30%, was measured on an anteroposterior radiograph of the pelvis with use of a reliable technique.

Results: A full data set was obtained for 323 (86%) of 374 children in the Register for the birth years 1990 through 1992. The mean duration of follow-up was eleven years and eight months. The incidence of hip displacement for the entire birth cohort was 35%, and it showed a linear relationship with the level of gross motor function. The incidence of hip displacement was 0% for children with GMFCS level I and 90% for those with GMFCS level V. Compared with children with GMFCS level II, those with levels III, IV, and V had significantly higher relative risks of hip displacement (2.7, 4.6, and 5.9, respectively).

Conclusions: Hip displacement is common in children with cerebral palsy, with an overall incidence of 35% found in this study. The risk of hip displacement is directly related to gross motor function as graded with the Gross Motor Function Classification System. This information may be important when assessing the risk of hip displacement for an individual child who has cerebral palsy, for counseling parents, and in the design of screening programs and resource allocation.

Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
H. K. Graham, R. Boyd, J. B. Carlin, F. Dobson, K. Lowe, G. Nattrass, P. Thomason, R. Wolfe, and D. Reddihough
Does Botulinum Toxin A Combined with Bracing Prevent Hip Displacement in Children with Cerebral Palsy and "Hips at Risk"? A Randomized, Controlled Trial
J. Bone Joint Surg. Am., January 1, 2008; 90(1): 23 - 33.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
D. J. Sucato and Y.-J. Kim
What's New in Pediatric Orthopaedics
J. Bone Joint Surg. Am., May 1, 2007; 89(5): 1141 - 1150.
[Full Text] [PDF]