It is very important that all children with cerebral palsy be evaluated and screened for hip problems during the course of their growth and development. This is usually done by a complete physical examination in addition to x-rays of the hip. X-rays of the hip are required every 6-12 months depending on the level of the spasticity and functional ambulation of the child.
The hip is the second most common involved joint (after ankle) in children with cerebral palsy. The hip is a ball and socket joint and for its proper function and painless movement, the ball (femoral head) should be located inside the socket (acetabulum). The hip joint is under higher pressure due to tight muscles in children with cerebral palsy. These high pressures could gradually displace the ball out of socket resulting in early arthritis and painful hips. The displaced painful hips are usually debilitating both in the group of children that walk using assistive devices and in children who use wheelchairs for mobility.
Early stages of the hip disease in children with cerebral palsy could easily be overlooked since the child does not complain of any pain. If the treatment is not started in time, this could rapidly progress resulting in a painful displaced hip which could affect the ambulation and the quality of life. By the time to child starts complaining of pain, the hip is usually displaced out of the socket and the treatment options at that stage are very limited.
Early stages of hip displacement could easily be treated by simple procedures on the muscles of the hip. Advanced stages of hip involvement would require extensive reconstructive procedures involving the hip and the pelvis.
By routine and timely screening of all children with cerebral palsy for hip problems, this debilitating problem can easily be avoided.
The experienced team of St. Louis Children’s Hospital's orthopedic department perform screenings and treatments of all musculoskeletal conditions associated with cerebral palsy, including hip problems. Dr. Pooya Hosseinzadeh, a Washington University pediatric orthopedic surgeon at St. Louis Children's Hospital, specializes in the orthopedic management of children with cerebral palsy.