Related Experiment Video
Updated: Dec 14, 2025
The Use of Mixed Reality in Custom-Made Revision Hip Arthroplasty: A First Case Report
Published on: August 4, 2022
Team Approach: The Perioperative Management of Reconstructive Hip Surgery for the Non-Ambulatory Child with Cerebral
Rachel L DiFazio1, Laurie J Glader, Rachel Tombeno
11Boston Children's Hospital, Boston, Massachusetts 2Harvard Medical School, Boston, Massachusetts.
Insights
Cerebral palsy (CP) management requires monitoring hip stability, especially in non-ambulatory children with spastic hip subluxation. A multidisciplinary team approach is crucial for optimal perioperative care during reconstructive hip surgery.
Area of Science:
- Orthopedics
- Pediatrics
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is a leading cause of childhood physical disability, often accompanied by complex medical comorbidities.
- Spastic hip subluxation, a common orthopedic deformity in CP, increases with condition severity.
- Early hip surveillance is vital for monitoring hip stability in children with CP.
Observation:
- Reconstructive hip surgery is indicated for hip subluxation with a migration percentage greater than 40%.
- Perioperative care for these procedures necessitates a comprehensive, multidisciplinary team approach.
- The core team includes orthopedics, nursing, pediatrics, anesthesia, and physical therapy specialists.
Findings:
- Effective perioperative care integrates expertise from various medical and allied health professionals.
- A case scenario illustrates the team's role in managing a 7-year-old girl with CP and hip subluxation.
- The review emphasizes the collaborative nature of caring for non-ambulatory children undergoing hip reconstruction.
Implications:
- Optimizing perioperative care through a multidisciplinary team can improve outcomes for children with CP and hip subluxation.
- This approach highlights the importance of coordinated care for complex pediatric orthopedic conditions.
- Enhanced collaboration among specialists is key to addressing the multifaceted needs of children with CP.
Abstract:
Cerebral palsy (CP) is the leading cause of physical disability in children. Although physical disability is the hallmark of CP, children with CP also often have complex medical comorbidities. Spastic hip subluxation is the second most common orthopaedic deformity in children with CP, and the incidence increases with the severity of CP. Hip surveillance should be implemented in children with CP to monitor hip stability over time. A reconstructive surgical procedure is recommended when the migration percentage is >40%. Perioperative care of children undergoing a hip reconstructive surgical procedure is a multidisciplinary endeavor requiring the expertise of professionals with different backgrounds. The core team should comprise orthopaedic surgeons, nurses, nurse practitioners, pediatricians, nurse case managers, anesthesiologists, and physical therapists. Additional team members include nutritionists, clinical pharmacists, social workers, child life therapists, and consulting specialty services. This review describes the team approach to the perioperative care of non-ambulatory children with spastic hip subluxation undergoing a reconstructive hip surgical procedure, utilizing a case scenario of a 7-year old girl with CP and complex associated medical comorbidities.
More Related Videos
09:51The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
09:31Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018