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Australian hip surveillance guidelines for children with cerebral palsy: 5-year review

2015; Wiley; Volume: 57; Issue: 9 Linguagem: Inglês

10.1111/dmcn.12754

1469-8749

Meredith Wynter, Noula Gibson, Kate Willoughby, Sarah Love, Megan Kentish, Pam Thomason, H. Kerr Graham,

Streptococcal Infections and Treatments

Aim To ensure hip surveillance guidelines reflect current evidence of factors influencing hip displacement in children with cerebral palsy ( CP ). Method A three‐step review process was undertaken: (1) systematic literature review, (2) analysis of hip surveillance databases, and (3) national survey of orthopaedic surgeons managing hip displacement in children with CP . Results Fifteen articles were included in the systematic review. Quantitative analysis was not possible. Qualitative review indicated hip surveillance programmes have decreased the incidence of hip dislocation in populations with CP . The G ross M otor F unction C lassification S ystem was confirmed as the best indicator of risk for displacement, and evidence was found of hip displacement occurring at younger ages and in young adulthood. Femoral geometry, pelvic obliquity, and scoliosis were linked to progression of hip displacement. A combined data pool of 3366 children from Australian hip surveillance databases supported the effectiveness of the 2008 C onsensus Statement to identify hip displacement early. The survey of orthopaedic surgeons supported findings of the systematic review and database analyses. Interpretation This review rationalized changes to the revised and renamed A ustralian H ip S urveillance G uidelines for C hildren with C erebral P alsy 2014, informing frequency of radiographic examination in lower risk groups and continuation of surveillance into adulthood for adolescents with identified risk factors.