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Hip Dysplasia in Children with Cerebral Palsy

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Cerebral Palsy

Abstract

Neuromuscular hip dysplasia is common in children with cerebral palsy, especially those with GMFCS IV or V functional level. The pathophysiology of progressive hip subluxation and dislocation comes from abnormal muscle tone superimposed over growth and developmental delay. Proactive surgical care in the form of soft tissue releases and hip osteotomy is successful in stopping progressive subluxation and dislocation. Neglected hip dysplasia in CP leads to painful dislocations that can be treated with salvage surgical procedures but with lower success rates than preventive and reconstructive techniques.

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References

  1. Soo B, Howard JJ, Boyd RN, et al. Hip displacement in cerebral palsy. J Bone Joint Surg Am. 2006;88:121–9.

    PubMed  Google Scholar 

  2. Flynn JM, Miller F. Management of hip disorders in patients with cerebral palsy. J Am Acad Orthop Surg. 2002;10:198–209.

    Article  PubMed  Google Scholar 

  3. Terjesen T. The natural history of hip development in cerebral palsy. Dev Med Child Neurol. 2012;54:951–7.

    Article  PubMed  Google Scholar 

  4. Pruszczynski B, Sees J, Miller F. Risk factors for hip displacement in children with cerebral palsy: systematic review. J Pediatr Orthop. 2016;36:829–33.

    Article  PubMed  Google Scholar 

  5. Larnert P, Risto O, Hägglund G, Wagner P. Hip displacement in relation to age and gross motor function in children with cerebral palsy. J Child Orthop. 2014;8:129–34.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Hermanson M, Hägglund G, Riad J, Wagner P. Head-shaft angle is a risk factor for hip displacement in children with cerebral palsy. Acta Orthop. 2015;86:229–32.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Wawrzuta J, Willoughby KL, Molesworth C, et al. Hip health at skeletal maturity: a population based study of young adults with cerebral palsy. Dev Med Child Neurol. 2016;58:1273–80.

    Article  PubMed  Google Scholar 

  8. Howard CB, McKibbin B, Williams LA, Mackie I. Factors affecting the incidence of hip dislocation in cerebral palsy. J Bone Joint Surg Br. 1985;67:530–2.

    Article  CAS  PubMed  Google Scholar 

  9. Lonstein JE, Beck K. Hip dislocation and subluxation in cerebral palsy. J Pediatr Orthop. 1986;6:521–6.

    Article  CAS  PubMed  Google Scholar 

  10. Heidt C, Hollander K, Wawrzuta J, et al. The radiological assessment of pelvic obliquity in cerebral palsy and the impact on hip development. Bone Joint J. 2015;97:1435–40.

    Article  PubMed  Google Scholar 

  11. Faraj S, Atherton WG, Stott NS. Inter- and intra-measurer error in the measurement of Reimer’s hip migration percentage. J Bone Joint Surg Br. 2004;86:434–7.

    Article  CAS  PubMed  Google Scholar 

  12. Reimers J. The stability of the hip in children: a radiological study of the results of muscle surgery in cerebral palsy. Acta Orthop Scand Suppl. 1980;184:1–100.

    Article  CAS  PubMed  Google Scholar 

  13. Graham HK, Boyd R, Carlin JB, et al. 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. 2008;90:23–33.

    Article  PubMed  Google Scholar 

  14. Boyd RN, Hays RM. Current evidence for the use of botulinum toxin type A in the management of children with cerebral palsy: a systematic review. Eur J Neurol. 2001;8(Suppl 5):1–20.

    Article  PubMed  Google Scholar 

  15. Picciolini O, Albisetti W, Cozzaglio M, et al. “Postural management” to prevent hip dislocation in children with cerebral palsy. Hip Int. 2009;19:S56–62.

    Article  PubMed  Google Scholar 

  16. Picciolini O, Metayer M, Consonni D, et al. Can we prevent hip dislocation in children with cerebral palsy? Effects of postural management. Eur J Phys Rehabil Met. 2016;52:682–90.

    Google Scholar 

  17. Macias-Merlo L, Bagur-Calafat C, Girabent-Farrés M, A Stuberg W. Effects of the standing program with hip abduction on hip acetabular development in children with spastic diplegia cerebral palsy. Disabil Rehabil. 2016;38:1075–81.

    Article  PubMed  Google Scholar 

  18. Onimus M, Allamel G, Manzone P, Laurain JM. Prevention of hip dislocation in cerebral palsy by early psoas and adductors tenotomies. J Pediatr Orthop. 1991;11:432–5.

    Article  CAS  PubMed  Google Scholar 

  19. Abdo JC, Forlin E. Hip dislocation in cerebral palsy: evolution of the contralateral side after reconstructive surgery. Rev Bras Ortop. 2016;51:329–32.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Settecerri JJ, Karol LA. Effectiveness of femoral varus osteotomy in patients with cerebral palsy. J Pediatr Orthop. 2000;20:776–80.

    Article  CAS  PubMed  Google Scholar 

  21. Brunner R, Baumann JU. Long-term effects of intertrochanteric varus derotation osteotomy on femur and acetabulum in spastic cerebral palsy: an 11 to 18 year follow up study. J Pediatr Orthop. 1997;17:585–91.

    Article  CAS  PubMed  Google Scholar 

  22. Mazur JM, Danko AM, Standard SC, et al. Remodeling of the proximal femur after varus osteotomy in children with cerebral palsy. Dev Med Child Neurol. 2004;46:412–5.

    PubMed  Google Scholar 

  23. Zhang S, Wilson NC, Mackey AH, Stott NS. Radiological outcome of reconstructive hip surgery in children with gross motor classification system IV and V cerebral palsy. J Pediatr Orthop B. 2014;23:430–4.

    Article  PubMed  Google Scholar 

  24. McHale KA, Bagg M, Nason SS. Treatment of the chronically dislocated hip in adolescents with cerebral palsy with femoral head resection and subtrochanteric valgus osteotomy. J Pediatr Orthop. 1990;10:504–9.

    Article  CAS  PubMed  Google Scholar 

  25. Wright PB, Ruder J, Birnbaum MA, et al. Outcomes after salvage procedures for the painful dislocated hip in cerebral palsy. J Pediatr Orthop. 2013;33:505–10.

    Article  PubMed  Google Scholar 

  26. Kolman SE, Ruzbarsky JJ, Spiegel DA, Baldwin KD. Salvage options in the cerebral palsy hip: a systematic review. J Pediatr Orthop. 2016;36:645–50.

    Article  PubMed  Google Scholar 

  27. Hwang JH, Varte L, Kim HW, Lee DH, Park H. Salvage procedures for the painful chronically dislocated hip in cerebral palsy. Bone Joint J. 2016;98-B(1):137–43.

    Google Scholar 

  28. Shrader MW, Jones J, Falk MN, et al. Hip reconstruction is more painful than spine fusion in children with cerebral palsy. J Child Orthop. 2015;9:221–5.

    Article  PubMed  PubMed Central  Google Scholar 

  29. DiFazio R, Vessey JA, Miller P, et al. Postoperative complications after hip surgery in patients with cerebral palsy: a retrospective matched cohort study. J Pediatr Orthop. 2016;36:56–62.

    Article  PubMed  Google Scholar 

  30. Shore BJ, Yu X, Desai S, et al. Adductor surgery to prevent hip displacement in children with cerebral palsy: the predictive role of gross motor function classification system. J Bone Joint Surg Am. 2012;94:326–34.

    Article  PubMed  Google Scholar 

  31. Shore BJ, Zurakowski D, Dufreny C, et al. Proximal femoral varus derotation osteotomy in children with cerebral palsy: the effect of age, gross motor function classification system level, and surgeon volume on surgical success. J Bone Joint Surg Am. 2015;97:2024–31.

    Article  PubMed  Google Scholar 

  32. Hesketh K, Leveille L, Mulpuri K. The frequency of AVN following reconstructive hip surgery in children with cerebral palsy: a systematic review. J Pediatr Orthop. 2016;36:e17–24.

    Article  PubMed  Google Scholar 

  33. Sherrod BA, Baker DK, Gilbert SR. Blood transfusion incidence, risk factors, and associated complications in surgical treatment of hip dysplasia. J Pediatr Orthop. 2016.; [E pub ahead of print]

    Google Scholar 

  34. Refakis CA, Baldwin KD, Spiegel DA, Sankar WN. Treatment of the dislocated hip in infants with spasticity. J Pediatr Orthop. 2016.; [E pub ahead of print]

    Google Scholar 

  35. Buxbom P, Sonne-Holm S, Ellitsgaard N, Wong C. Stability and migration across femoral varus derotation osteotomies in children with neuromuscular disorders. Acta Orthop. 2016;28:1–7.

    Google Scholar 

  36. Reidy K, Heidt C, Dierauer S, Huber H. A balanced approach for stable hips in children with cerebral palsy: a combination of moderate VDRO and pelvic osteotomy. J Child Orthop. 2016;10:281–8.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Rutz E, Vavken P, Camathias C, et al. Long-term results and outcome predictors in one-stage hip reconstruction in children with cerebral palsy. J Bone Joint Surg Am. 2015;97:500–6.

    Article  PubMed  Google Scholar 

  38. Braatz F, Eidmüller A, Klotz M, et al. Hip reconstruction surgery is successful in restoring joint congruity in patients with cerebral palsy: long-term outcome. Int Orthop. 2014;38:2237–43.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Pediatric Orthopedic Surgery, Children’s of Mississippi, Jackson, MS, USA

    M. Wade Shrader M.D

  2. Department of Orthopedic Surgery, University of MS Medical Center, Jackson, MS, USA

    M. Wade Shrader M.D & Bopha Crea M.D.

Authors
  1. M. Wade Shrader M.D
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  2. Bopha Crea M.D.
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Correspondence to M. Wade Shrader M.D .

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Editors and Affiliations

  1. Division of Paediatric Neurology, Aristotle University of Thessaloniki Division of Paediatric Neurology, Thessaloniki, Greece

    Christos P. Panteliadis

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Shrader, M.W., Crea, B. (2018). Hip Dysplasia in Children with Cerebral Palsy. In: Panteliadis, C. (eds) Cerebral Palsy. Springer, Cham. https://doi.org/10.1007/978-3-319-67858-0_19

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  • DOI: https://doi.org/10.1007/978-3-319-67858-0_19

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-67857-3

  • Online ISBN: 978-3-319-67858-0

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