Abstract
Purpose
The purpose of this paper is to describe the outcomes of major hip surgery for children with cerebral palsy and communication difficulties using a validated health related quality of life measure and a validated pain score.
Method
Children with hypertonic bilateral cerebral palsy (CP) GMFCS levels IV and V, 2–15 years old, having femoral + /- acetabular osteotomies for hip displacement were included if their ability to communicate necessitated the use of the CPCHILD (Caregiver Priorities and Child Health Index of Life with Disabilities) and PPP (Paediatric Pain Profile). The underlying indication for surgery was a hip migration index of more than 40% . CPCHILD and PPP questionnaires were completed face-to-face with the parents or carers at baseline, at 3 months after surgery and at 6 months after surgery.
Results
There were 54 patients with a mean age of 8.8 years (SD 3.6). At baseline the mean CPCHILD was 52.1 (SD 11.8). At 3 months it was 58.5 (SD 13.1; p< 0.001). At 6 months it was 59.4 (SD 12.4; p< 0.001). This paper also describes the changes within each domain of the CPCHILD. At baseline the PPP was 12.7 (SD 7.2); at 3 months the PPP was 9.8 (SD 7.2; p< 0.01); at 6 months the PPP was 9.2 (SD 6.4; p< 0.001).
Conclusion
Hip reconstruction for displacement is a major intervention for an often asymptomatic condition. This paper confirms that health related quality of life (measured by the CPCHILD) and pain (measured by the PPP) return to baseline or better than baseline within 3 months of surgery and that this is maintained at 6 months. These results should be reassuring for families and healthcare workers looking after children with severe disability undergoing surgery of this sort.
