Open AccessRisk factors for hip dislocation in dyskinetic cerebral palsy
Author(s) -
Kyoko Okuno,
Yukihiro Kitai,
Toru Shibata,
Hiroshi Arai
Publication year - 2021
Publication title -
journal of orthopaedic surgery
Language(s) - English
Resource type - Journals
eISSN - 2309-4990
pISSN - 1022-5536
DOI - 10.1177/23094990211001196
Subject(s) - medicine , cerebral palsy , gross motor function classification system , magnetic resonance imaging , globus pallidus , odds ratio , gestational age , logistic regression , radiology , physical therapy , basal ganglia , pregnancy , central nervous system , genetics , biology
Purpose: To investigate the risk factors for hip displacement in patients with dyskinetic cerebral palsy (DCP).Methods: We evaluated 81 patients with DCP, 45 males and 36 females, aged 10–22 years, risk factors for hip displacement were evaluated using multivariate logistic regression analysis with primary brain lesions, Gross Motor Function Classification System (GMFCS) level, gestational age, birth weight, Cobb’s angle, and complication of epilepsy as independent factors. Hip displacement was defined as migration percentage >30%. Primary brain lesions were classified into globus pallidus (GP), thalamus and putamen (TP), and others using brain magnetic resonance imaging (MRI). Perinatal and clinical features were compared between patients with GP lesions and those with TP lesions.Results: Hip displacement was observed in 53 patients (67%). Higher GMFCS levels (p = 0.013, odds ratio [OR] 2.6) and the presence of GP lesions (p = 0.04, OR 16.5) were independent risk factors for hip displacement. Patients with GP lesions showed significantly higher GMFCS levels, more frequent hip displacement, and lower gestational age and birth weight than those with TP lesions.Conclusion: Primary brain lesion location may be an important factor in predicting hip displacement among patients with DCP. Appropriate risk assessment using brain MRI may contribute to the early detection and intervention of hip displacement because brain lesion location can be assessed during infancy before GMFCS level is decided.