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Hip Surveillance in Children With Cerebral Palsy

Shrader, M. Wade MD; Wimberly, Lane MD; Thompson, Rachel MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: October 15, 2019 - Volume 27 - Issue 20 - p 760-768
doi: 10.5435/JAAOS-D-18-00184
Review Article

Hip dysplasia is common in children with cerebral palsy (CP), especially in those children with notable functional impairment. Severity of hip dysplasia has been shown to correlate with higher Gross Motor Function Classification System levels. Migration percentage measured on AP pelvis radiographs is the key radiographic measure quantifying hip displacement in CP. Hip surveillance programs for children with CP exist in Europe, Australia, and parts of Canada and have been adopted as standard of care. These programs have demonstrated improved detection of hip subluxation and appropriate early intervention with a resultant decrease in the number of painful dislocations. Hip surveillance programs provide healthcare providers with guidance for a schedule of obtaining hip radiographs based on patients' age, Gross Motor Function Classification System level, and migration percentage. Although systematic surveillance programs have yet to be adopted in the United States, several centers and organizations are currently investigating the potential and efficacy of hip screening in CP.

From the Department of Orthopedics, Alfred I. duPont Hospital for Children, Wilmington, DE (Dr. Shrader), the Texas Scottish Rite Hospital for Children, Dallas, TX (Dr. Wimberly), and the Orthopedic Institute for Children, University of California in Los Angeles, Los Angeles, CA (Dr. Thompson).

Dr. Shrader or an immediate family member serves as a paid consultant to Orthopediatrics and serves as a board member, owner, officer, or committee member of AACPDM. Neither of the following authors nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Wimberly and Dr. Thompson.

Copyright 2019 by the American Academy of Orthopaedic Surgeons.
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