Radiographic Hip Screening in Cerebral Palsy: Developing POSNA-Wide Consensus

Abstract

Population based studies have found that approximately 33% of children with cerebral palsy are at risk for progressive lateral hip displacement/subluxation during childhood. There is growing evidence supporting the practice of hip surveillance for children with cerebral palsy and many developed countries have established national and state surveillance programs. However, across POSNA there is a lack of consensus regarding a radiographic hip screening protocol for children with cerebral palsy. Therefore, the purpose of this quality initiative was to develop a POSNA-wide radiographic hip screening schedule using a Modified Delphi technique. A group of 24 pediatric orthopedic surgeons participated in the Modified Delphi technique to achieve consensus regarding a hip radiographic screening protocol. The development of a POSNA - wide radiographic hip screening protocol has the potential to standardize screening practices across our society, decrease practice variation and ultimately improve the quality of health care delivery for children with cerebral palsy and other neuromuscular conditions.

A Multidisciplinary Perioperative Care Coordination Pathway for Hip and Spine Reconstruction in Non-ambulatory Patients with Cerebral Palsy

“…These surveillance guidelines are based on prior work from Australia, with adoption by other societies (e.g., AACPDM, POSNA). 18,19 Regular visits with the surgeon give families an opportunity to ask questions regarding natural history, management options, and discussion of long-term outcomes. This patient-doctor relationship allows surgeons to introduce the concept of surgical intervention to the family with Shared Decision Making (SDM) techniques.…”