[논문]Progression of Hip Displacement during Radiographic Surveillance in Patients with Cerebral Palsy

Park, Jae Young; Choi, Young; Cho, Byung Chae; Moon, Sang Young; Chung, Chin Youb; Lee, Kyoung Min; Sung, Ki Hyuk; Kwon, Soon-Sun; Park, Moon Seok

doi:10.3346/jkms.2016.31.7.1143

Progression of Hip Displacement during Radiographic Surveillance in Patients with Cerebral Palsy 원문보기

Journal of Korean medical science : JKMS, v.31 no.7, 2016년, pp.1143 - 1149

Park, Jae Young (Department of Orthopaedic Surgery, 21th Century Hospital, Wonju, Korea .) , Choi, Young (Department of Orthopaedic Surgery, Kosin University Gospel Hospital, Busan, Korea .) , Cho, Byung Chae (Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea .) , Moon, Sang Young (Yeollin Orthopedic Clinic, Suwon, Korea .) , Chung, Chin Youb (Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea .) , Lee, Kyoung Min (Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea .) , Sung, Ki Hyuk (Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea .) , Kwon, Soon-Sun (Department of Mathematics, College of Natural Science, Ajou University, Suwon, Korea .) , Park, Moon Seok (Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea .

Abstract ▼ AI-Helper

Progression of hip displacement is common in patients with cerebral palsy (CP). We aimed to investigate the rate of progression of hip displacement in patients with CP by assessing changes in radiographic indices according to Gross Motor Function Classification System (GMFCS) level during hip surveillance. We analyzed the medical records of patients with CP aged < 20 years who underwent at least 6 months interval of serial hip radiographs before any surgical hip intervention, including reconstructive surgery. After panel consensus and reliability testing, radiographic measurements of migration percentage (MP), neck-shaft angle (NSA), acetabular index (AI), and pelvic obliquity (PO) were obtained during hip surveillance. For each GMFCS level, annual changes in radiographic indices were analyzed and adjusted for affecting factors, such as sex, laterality, and type of CP. A total of 197 patients were included in this study, and 1,097 radiographs were evaluated. GMFCS classifications were as follows: 100 patients were level I-III, 48 were level IV, and 49 were level V. MP increased significantly over the duration of hip surveillance in patients with GMFCS levels I-III, IV, and V by 0.3%/year (P < 0.001), 1.9%/year (P < 0.001), and 6.2%/year (P < 0.001), respectively. In patients with GMFCS level IV, NSA increased significantly by 3.4°/year (P < 0.001). Our results suggest that periodic monitoring and radiographic hip surveillance is warranted for patients with CP, especially those with GMFCS level IV or V. Furthermore, physicians can predict and inform parents or caregivers regarding the progression of hip displacement in patients with CP.

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참고문헌 (35)

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DOI : 10.3346/jkms.2016.31.7.1143 [무료]
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