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A classification system for hip disease in cerebral palsy

Jonathan Robin1, H Kerr Graham, Richard Baker

  • 1Murdoch Childrens Research Institute, The University of Melbourne, Department of Orthopaedic Surgery, The Royal Children's Hospital, Parkville, Victoria, Australia.

Developmental Medicine and Child Neurology
|December 6, 2008
PubMed

Insights

A new classification system for hip morphology in children with cerebral palsy (CP) has been developed. This system aids in auditing hip displacement, understanding its relationship with CP subtypes, and improving communication among healthcare professionals.

Area of Science:

  • Orthopedics
  • Pediatric Neurology
  • Radiology

Background:

  • Hip displacement affects approximately one-third of children with cerebral palsy (CP).
  • The wide spectrum of CP phenotypes leads to varied hip development, ranging from normal to dislocation and degenerative arthritis.
  • Existing radiological indices lack a standardized grading system for hip status in CP, hindering research and clinical communication.

Purpose of the Study:

  • To develop a categorical, radiographic classification system for hip morphology in children with cerebral palsy.
  • To address the need for a standardized method to audit hip displacement, correlate it with CP subtypes, and assess intervention outcomes.

Main Methods:

  • Development of a classification system based on qualitative indices and Reimer's migration percentage.
  • Review of 134 radiographs from adolescents (mean age 16 years) with CP across Gross Motor Function Classification System (GMFCS) levels I-V.
  • Classification of hip morphology encompassing varying degrees of displacement and intervention status.

Main Results:

  • A comprehensive classification system was successfully developed to categorize hip morphology in CP.
  • The system accommodates the full spectrum of hip conditions observed in CP, from normal development to severe displacement.
  • Radiographs from a diverse cohort of adolescents with CP, stratified by GMFCS level, were analyzed.

Conclusions:

  • The developed categorical classification system provides a standardized approach to assessing hip morphology in cerebral palsy.
  • This system facilitates improved auditing, research on CP subtypes and hip displacement, and clinical communication.
  • The classification is applicable to hips with and without prior intervention.

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