Verification of the Robin and Graham classification system of hip disease in cerebral palsy using three-dimensional...

Area of Science:

• Orthopedics
• Pediatric Imaging
• Biomedical Engineering

Background:

• Hip disease is a common complication in children with cerebral palsy (CP).
• Accurate classification systems are crucial for guiding treatment and predicting outcomes.
• The Robin and Graham classification is a widely used system for hip disease in CP.

Purpose of the Study:

• To evaluate the validity of the Robin and Graham classification system for hip disease in young individuals with cerebral palsy.
• To compare measurements from three-dimensional computed tomography (3D-CT) with the Robin and Graham classification.
• To assess the reliability of the classification system in a pediatric CP population.

Main Methods:

• Retrospective analysis of 91 hips in 91 children with bilateral spastic CP (ages 2-6 years).
• Inclusion of anteroposterior plain radiographs and 3D-CT scans of the hip.
• Classification into four groups based on migration percentage, with subsequent 3D-CT measurements of acetabular and femoral parameters.

Main Results:

• Significant differences in lateral opening angle and neck-shaft angle were observed across the four classification groups (p ≤ 0.001).
• 3D-CT quantitative evaluation demonstrated distinct morphological variations correlating with the Robin and Graham grades.
• The study identified specific 3D-CT parameters that support the Robin and Graham classification.

Conclusions:

• The three-dimensional quantitative evaluation validates the Robin and Graham classification system for hip disease in children with CP aged 2-7 years.
• This study supports the continued use of the Robin and Graham classification in clinical practice for pediatric CP hip disease.
• 3D-CT provides valuable insights into the morphological changes underlying hip disease in CP, supporting existing classification systems.