Hip subluxation in Italian cerebral palsy children and its determinants: a retrospective cohort study.
Silvia Faccioli, Silvia Sassi, Adriano Ferrari and 5 others
PMID 36059222WHAT IT FOUND
Hip displacement worsens fastest in early childhood and around puberty.
Standing and walking devices with weight relief were linked to lower migration, especially when combined with botulinum. Surgery reduced displacement, but soft tissue surgery did not prevent progression long-term.
Key findings
01Migration percentage was lower in hips treated with standing and walking devices, and botulinum combined with standing devices reduced yearly progression in GMFCS V.
02Bone surgery significantly reduced migration percentage, while soft tissue surgery was associated with higher migration values but slower yearly progression.
03Hip displacement progression peaked at age 2 and increased again around puberty, with spastic CP showing higher migration than dyskinetic CP.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was retrospective and relied on existing clinical charts, so it cannot prove that treatments caused the observed changes. Patients were recruited from a single tertiary referral centre, meaning they may have had more severe hip issues than the general population. Precise data on how long patients used standing or walking devices were missing, so dose-response relationships could not be assessed. Botulinum injections were not specified by muscle, making it difficult to determine the exact nature of the treatment. The sample included only the most severe non-ambulatory children, so findings may not apply to children with milder cerebral palsy.
Declared interests
There are no conflicts of interest declared.
The easy way to misread this
Do not assume that standing devices or botulinum injections will prevent hip surgery or reverse severe displacement. The study shows associations, not causation, and the authors note that conservative approaches are unlikely to be effective for migration percentages of 50% or higher.