Children with cerebral palsy (CP) are at risk of developing progressive hip displacement. It’s early detection is an essential part of the strategy for prevention of further hip displacement and its sequelae. Hip surveillance is the process of identifying and monitoring the critical early indicators of hip displacement.
The AusACPDM previously endorsed the Consensus Statement on Hip Surveillance for Children with Cerebral Palsy: Australian Standards of Care 2008 (Consensus Statement)1 which was launched at the 3rd International Cerebral Palsy Conference in Sydney Australia, February 2009.
In 2013 a National Hip Surveillance Working Group was established to review the Consensus Statement.
- To understand the latest evidence for hip surveillance and how this may impact the Consensus Statement.
- To develop an understanding of how the Consensus Statement is currently being implemented in various states of Australia.
- To gain knowledge of outcomes of surveillance services in various states of Australia.
A three-step review process was undertaken:
- A systematic literature review of the effectiveness of hip surveillance, and of factors influencing hip displacement in children with CP
- Analysis of data from Australian State established hip surveillance databases, where available
- A national survey of orthopaedic surgeons who manage hip displacement in children with CP.
The results from this review process have been accepted for publication in 2015. The review indicated that hip surveillance programs have decreased the incidence of hip dislocation in populations with CP and the Gross Motor Function Classification System remains the best indicator of risk for displacement.
A combined data pool of 3366 children from Australian hip surveillance databases supported the effectiveness of the 2008 Consensus Statement to identify hip displacement early. The survey of orthopaedic surgeons supported findings of the systematic review and database analyses.
The review provided rationale for changes to the revised and renamed Australian Hip Surveillance Guidelines for Children with Cerebral Palsy 2014, informing decreased frequency of radiographic examination in lower risk groups and continuation of surveillance into adulthood for adolescents with identified risk factors.
- Wynter M; Gibson N; Kentish M; Love S; Thomason P; Graham HK. The Consensus Statement on Hip Surveillance for Children with Cerebral Palsy: Australian Standards of Care.
Journal of Pediatric Rehabilitation Medicine. 4(3):183-95, 2011.