WELCOME CP Hip Symposium

History of CP hip concern Surgical Treatment in CP 1. First CP deformity-Ankle 2. Adducted dislocated hip (adductor lengthening and varus osteotomy) DDH treatment 1960s and 70s-great interest in DDH Developed screening, harness treatment Indications for surgical treatment Pelvic Osteotomies-Salter, Pemberton Dega-first report in 1932, most common in Eastern Europe DDH Treatment 1960s through 1980s Development of many Salvage procedure Cairi, Triple (Steele and Sutherland) Colona and periacetabular Neurologic Hip VS DDH Most Surgeons developing DDH procedures seemed to have little interest in the CP or Myleo Hips Salter would specifically say his procedure has no role in CP or Myleo There was no understanding of the differences between pathologies Modern CP Hip Treatment Dr. Mercer Rang promoted the concept of the differences in pathologies Took the DDH screening concept and developed CP hip screening, heavily promoted it to therapist in Ontario With Jurgen Reimers worked out the importance of x-ray measures Modern CP hip treatment In the 1980s understanding of the importance of acetabular deformity Led to the independent Development Osteotomies to provide posterior lateral acetabular coverage Dega's Osteotomy was discovered or reinvented, by DDH trained surgeons Prevention-the phase in the process when addressing the etiology can prevent the secondary deformities Reconstruction-Stage when the hip joint deformity can be corrected to have a long-term functioning hip joint Salvage-Palliation-cannot save hip Introduction: Hip displacement (HD) is the second most common musculoskeletal deformity affecting children with Cerebral Palsy (CP). The primary aim of this study was to investigate the relationship between HD in individuals with severe CP, and caregiver-reported level of comfort associated with daily activity, positioning and overall quality of life (QoL), as described in the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD). The secondary aim was to identify differences in these outcomes in comparing surgical and non-surgical management for HD. Methodology: In this cross-sectional study 25 participants (50 hips) from an eligible total of 57 non-ambulant children with CP [Gross Motor Functional Classification System, (GMFCS) levels IV and V], born between 1988-1998 were recruited from a state-based population registry. Parents/caregivers completed the CPCHILD questionnaire. A blinded assessment of hip Migration Percentage (MP) and a morphological hip classification was made for each hip from the most recent radiograph. Statistical analysis included linear modeling and Pearson correlations. Results: Mean age was 15.2 years (SD 3.0; range 10.1-20.9 years), 68% were male; at GMFCS level IV (28%) and …