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Hip joint pain in spastic dislocation: aetiological aspects

Adrian Masłoń1, Marek Jóźwiak, Maciej Pawlak

  • 1Clinic of Orthopaedics and Paediatric Orthopaedics, Medical University of Lodz, Lodz, Poland. adian@gazeta.pl

Developmental Medicine and Child Neurology
|August 19, 2011
PubMed

Insights

Children with cerebral palsy (CP) and dislocated hips experience pain due to increased nociceptors. This study found a direct correlation between nerve fiber density and pain intensity in these children.

Area of Science:

  • Pediatric Orthopedics
  • Neuroscience
  • Pain Management

Background:

  • Children with severe cerebral palsy (CP) often develop hip joint displacement, leading to significant pain in 40-84% of cases.
  • Understanding the biological basis of this pain is crucial for effective management.

Purpose of the Study:

  • To investigate the correlation between nociceptor density in the hip joint capsule and teres ligament and the presence of hip joint pain in children with spastic CP.
  • To identify potential biomarkers for hip pain in this population.

Main Methods:

  • Analysis of 19 hip joint samples (articular capsule and teres ligament) from non-ambulatory children with spastic CP (GMFCS level V).
  • Assessment of pain using a numeric rating scale completed by caregivers.
  • Immunohistochemical comparison of S-100 and substance P positive nerve fibers between painful and painless hip joints.

Main Results:

  • Significantly higher levels of S-100 protein and substance P were observed in children with painful hip joints (p=0.024 and p=0.02, respectively).
  • Positive correlations were found between pain intensity and the density of S-100 and substance P positive nerve fibers in both the teres ligament and joint capsule.

Conclusions:

  • Increased nociceptor density, indicated by elevated S-100 and substance P, is associated with hip joint pain in children with spastic CP.
  • Inflammatory factors in dislocated hip joints contribute to hip joint sensitization and pain.
Abstract

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