Risk factors for hip dislocation in spastic cerebral palsy

Abstract Background and objectives: Hip dislocation is a prevalent occurrence among children afflicted with spastic cerebral palsy. It has the potential to induce impairment of function, and a decline in the quality of life. Early prevention and management of hip dislocation remains an intricate problem. Our objective is to elucidate the risk factors influencing hip dislocation in children with spastic cerebral palsy. Methods: We included children with spastic cerebral palsy who were admitted to Dongzhimen Hospital, Beijing University of Chinese Medicine between January 2016 and January 2023. Participants' comprehensive clinical information, encompassing aspects such as gender, age, gestational age, birth weight, Gross Motor Function Classification System (GMFCS) level, and age of first standing, could be meticulously retrieved from medical records. All participants underwent pelvic X-ray examination. The severity of hip dislocation was assessed through the meticulous calculation of the Migration Percentage (MP) of the femoral head. Meanwhile, Acetabular Index (AI) and Neck-Shaft Angle (NSA) were obtained. Correlation analysis and multiple linear regression analysis were performed in the subsequent process. Results: A total of 291 patients (206 males and 85 females) fulfilled the inclusion criteria and were subsequently included in the analytical scope. The mean age was 8.3 years, ranging from 2 to 16 years. Correlation analysis showed that gender, age, gestational age, and birth weight were not related to MP ( p > 0.05). Multiple linear regression analysis revealed that GMFCS level ( p < 0.001), AI ( p < 0.001), NSA ( p < 0.001), and age of first standing ( p < 0.001) bore the stature of independent risk factors for MP. Conclusions: Our finding has revealed that GMFCS level, AI, NSA, and age of first standing are independent risk factors for the progression of MP in spastic cerebral palsy children. This study provided a new insight for the anticipation of hip dislocation.