Why do Hip Surveillance?

Children with cerebral palsy are at a high-risk for developing progressive hip dysplasia, or malformation of the hip joint.  Though children who do not walk are at highest risk, even those with mild cerebral palsy may have silent hip dysplasia that may become painful it not treated.  

 

High-quality evidence from numerous medical studies has shown that regular x-ray examinations of the hips can detect hip problems before they cause symptoms, allowing for earlier and more effective treatment.  "Hip Surveillance" is a regular schedule of clinical examinations and x-rays during the course of childhood that is proven to improve function in children with cerebral palsy.   

1 in 3

Over one-third of children with cerebral palsy will develop hip displacement or dysplasia. Even children with mild cerebral palsy are at risk.

1 in 5

20% of children with severe cerebral palsy will develop a hip dislocation.

50%

Half of children with a hip dislocation will develop pain and problems with sitting, even if they do not walk.

Zero

Sweden was able to completely eliminate hip dislocation in children with cerebral palsy using a Hip Surveillance Program. 

References: 

  1. Cooperman DR, et al. Hip dislocation in spastic cerebral palsy: long term consequences. Journal of Pediatric Orthopaedics 1987;7:268-76.

  2. Dobson F, et al.  Hip surveillance in children with cerebral palsy: Impact on the surical management of spastic hip disease. Journal of Bone and Joint Surgery [Br] 2002; 84-B:720-6.

  3. Hagglund G, et al. Prevention of dislocation of the hip in children with cerebral palsy: 20-year results of a population-based prevention programme.  Bone Joint Journal 2014;96-B:1546-52.

  4. Jung NH, et al. Does hip displacement influence health-related quality of life in children with cerebral palsy? Developmental Neurorehabilitation. 2014;17(6):420-5

 

© Shriners Hospitals for Children

Vedant Kulkarni, MD

Department of Orthopaedic Surgery

2425 Stockton Blvd

Sacramento, CA 95817