Affiliations: Queensland Cerebral Palsy Health Service, Royal
Childrens Hospital, Brisbane, QLD, Australia | Queensland Cerebral Palsy and Rehabilitation Research
Centre, The School of Medicine, The University of Queensland, QLD,
Australia | Queensland Children's Medical Research Institute, The
University of Queensland, QLD, Australia
Abstract: This study reports the five-year outcomes of a prospective
population-based study of clinical hip surveillance for children with cerebral
palsy (CP) according to evidence-based standards of care. Systematic hip
surveillance commenced in Queensland, Australia as a state-wide program in
2005. Queensland represents a dispersed population across a large geographical
area, creating unique challenges in terms of service delivery. Over five years,
1,115 children with CP were recruited, representing 73% of the expected
population based on 1.9 to 2.1 per 1,000 live births. Standardized clinical and
radiological assessments have been provided, with a median follow-up of 1.2
years (range 1 month −5^{+8} yrs). Of the 1,115 children, 423 (38%) have
been discharged and 692 (62%) remain on surveillance with 314 (28%)
identified as having hip displacement with Migration Percentage (MP) equal to
or greater than 30% (⩾ 30). The incidence of marked hip displacement
(MP ⩾ 30) was directly related to gross motor function, classified
according to the gross motor function classification system (GMFCS), with
distribution of GMFCS I=10, (3%), II=40 (13%), III=53
(43%), IV=96 (59%), and V=115 (64%). This state-wide
surveillance program has been successful in correctly identifying children with
hip displacement (MP ⩾ 30), fast tracking children for orthopedic review
and discharging those at minimal risk. No child has progressed to dislocation
while on surveillance without orthopedic review.
Keywords: Hip surveillance, Cerebral Palsy, children, guidelines, standards of care, hip displacement, hip dislocation
