Hip health at skeletal maturity: a population‐based study of young adults with cerebral palsy

• Published in: Developmental medicine and child neurology 2016-12, Vol.58 (12), p.1273-1280
• Main Authors: Wawrzuta, Joanna, Willoughby, Kate L, Molesworth, Charlotte, Ang, Soon Ghee, Shore, Benjamin J, Thomason, Pam, Graham, H Kerr
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Arthralgia - diagnosis; Arthralgia - epidemiology; Arthralgia - physiopathology; Cerebral Palsy - diagnostic imaging; Cerebral Palsy - epidemiology; Cerebral Palsy - physiopathology; Cohort Studies; Female; Hip - diagnostic imaging; Hip - physiopathology; Hip Dislocation - diagnostic imaging; Hip Dislocation - epidemiology; Hip Dislocation - physiopathology; Humans; Male; Registries; Severity of Illness Index; Victoria - epidemiology; Young Adult
• ISSN: 0012-1622; 1469-8749
• DOI: 10.1111/dmcn.13171

Aim We studied ‘hip health’ in a population‐based cohort of adolescents and young adults with cerebral palsy to investigate associations between hip morphology, pain, and gross motor function. Method Ninety‐eight young adults (65 males, 33 females) from the birth cohort were identified as having developed hip displacement (migration percentage >30) and were reviewed at a mean age of 18 years 10 months (range 15–24y). Hip morphology was classified using the Melbourne Cerebral Palsy Hip Classification Scale (MCPHCS). Severity and frequency of pain were recorded using Likert scales. Gross motor function was classified by the Gross Motor Function Classification System (GMFCS). Results Hip pain was reported in 72% of participants. Associations were found between pain scores and both hip morphology and GMFCS. Median pain severity score for MCPHCS grades 1 to 4 was 2 (interquartile range [IQR] 1.0–3.0) compared to 7 (IQR 6.0–8.0) for grades 5 and 6 (severe subluxation or dislocation). Hip surveillance and access to surgery were associated with improved hip morphology and less pain. Interpretation Poor hip morphology at skeletal maturity was associated with high levels of pain. Limited hip surveillance and access to surgery, rather than GMFCS, was associated with poor hip morphology. The majority of young adults who had access to hip surveillance, and preventive and reconstructive surgery, had satisfactory hip morphology at skeletal maturity and less pain. This article is commented on by Bauer on page 1208 of this issue.