Prevalence of hip dislocation and subluxation among children with cerebral palsy: an institution-based cross-sectional study from a Sub-Saharan country.

BACKGROUND: Hip dislocation in children with cerebral palsy (CP) presents significant challenges, including pain, and severe contractures, which impair positioning, sitting, standing, and walking. This study investigated the prevalence and factors associated with hip displacement in a cohort of children with CP in a resource-limited setting lacking a dedicated hip surveillance program. METHODS: A cross-sectional study was conducted from August 1, 2023, to January 30, 2024, at Tikur Anbesa Hospital, Ethiopia's largest tertiary hospital. The study included 141 children with CP who met the inclusion criteria and underwent hip radiography. The hip migration percentage was assessed, with hip subluxation defined as a migration percentage between 30% and 80% and hip dislocation defined as a percentage greater than 80%. The migration percentages were analyzed in relation to sociodemographic and clinical data via statistical tests. RESULTS: The study cohort predominantly consisted of children with spastic tetraplegic CP (56.7%), and 52.6% had GMFCS levels IV and V. A high comorbidity rate was observed, with 98% of the children having additional conditions, the most common being epilepsy (59%). The prevalence of hip displacement was 28%, with 88% of these cases classified as hip subluxation and nearly 11% as dislocation. Displacement was more common in the left hip (56.4%) than in the right hip or both hips. Osteopenia was present in 3.5% of the children. Factors associated with hip displacement included home rehabilitation, frequency of carrying by caregivers, GMFCS levels, and being aged 5-10 years. CONCLUSIONS: This study highlights the significant prevalence of hip displacement among children with CP in a resource-limited setting, despite being managed at a tertiary hospital. The findings underscore the need for the implementation of hip surveillance programs and timely interventions to prevent or mitigate hip displacement, thereby enhancing the quality of life and functional outcomes of these children.