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Neuromuscular Hip Disorders: Focus on Cerebral Palsy

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Hip Arthroscopy and Hip Joint Preservation Surgery

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Abstract

Cerebral palsy (CP) is the most frequent cause of chronic orthopedic disorders in children. Hip dysplasia occurs secondary to delayed walking and excessive muscle tone. The hip flexors and adductors overpower the hip extensors and abductors causing the femoral head to pull out of socket, most commonly in a posterolateral direction. Children with CP should be evaluated on a regular basis – both clinically and radiographically. Walking by 30 months significantly lowers the child’s risk of hip problems. An anteroposterior pelvis radiograph is used to assess for hip subluxation. A young patient with an at-risk hip (Migration Index <30 %) should undergo a soft-tissue operation. If subluxation is significant, a varus derotation osteotomy is indicated along with a soft-tissue operation. If the acetabulum is dysplastic, then an acetabuloplasty is also indicated. For chronic non-reducible painful hips, a salvage operation should be considered.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Rush University Medical Center, 1611 West Harrison Street, Chicago, IL, 60612, USA

    Michael D. Hellman

  2. Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Leon Root

  3. Department of Orthopaedic Surgery, Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL, 60612, USA

    Monica Kogan

  4. Pediatric Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Monica Kogan

Authors
  1. Michael D. Hellman
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  2. Leon Root
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  3. Monica Kogan
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Corresponding author

Correspondence to Michael D. Hellman .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA

    Shane J. Nho

  2. Department of Orthopaedic Surgery, Schulthess Klinik, Zurich, Switzerland

    Michael Leunig

  3. Minnesota Orthopedic Sports Medicine Institute, Twin Cities Orthopedics - Edina, Edina, Minnesota, USA

    Christopher M. Larson

  4. Department of Orthopaedics, University of Michigan, Ann Arbor, Michigan, USA

    Asheesh Bedi

  5. Sports Medicine and Shoulder Service and Center for Hip Preservation Surgery, Hospital for Special Surgery, New York, New York, USA

    Bryan T. Kelly

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© 2015 Springer Science+Business Media New York

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Hellman, M.D., Root, L., Kogan, M. (2015). Neuromuscular Hip Disorders: Focus on Cerebral Palsy. In: Nho, S., Leunig, M., Larson, C., Bedi, A., Kelly, B. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6965-0_42

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  • DOI: https://doi.org/10.1007/978-1-4614-6965-0_42

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-6964-3

  • Online ISBN: 978-1-4614-6965-0

  • eBook Packages: MedicineReference Module Medicine

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