Long-Term Outcomes of Hip Interventions for Children With Cerebral Palsy

MI-összefoglaló

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The trial is looking for children with severe cerebral palsy who cannot walk and whose hip is moving out of its socket. It follows how different hip treatments work out over the long term.

Életkor

2 to 19 years

Nem

All sexes

A betegség stádiuma

Severe cerebral palsy, unable to walk (GMFCS IV & V), with hip displacement seen on X-ray (Reimer's MP ≥ 30%).

Korábbi kezelés

The hip displacement must not have been treated before.

Biomarker vagy leletérték

Reimer's migration percentage (MP) of 30% or more on X-ray.

A részvétel fő kizáró okai

• Younger than 2 or older than 19
• Reimer's migration percentage under 30% in both hips
• Parents or main caregivers cannot fill in the CPCHILD questionnaire in one of its available languages

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• 2 és 19 év között vagy?IgenNem

Mit akar kideríteni a vizsgálat

Children with severe cerebral palsy (CP) are at high risk for progressive hip displacement, associated with pain and contractures interfering with many aspects of care, comfort and quality of life. These children undergo many types of interventions, the optimal timing and effectiveness of which, remain unclear. In 2014, CIHR funded the CP Hip Outcomes Project (CHOP), an international multi-centre prospective longitudinal cohort study of children with severe (non-ambulant) CP with evidence of hip displacement defined as a Reimer's migration percentage (MP) of at least 30%. The study was designed to evaluate the comparative effectiveness of different treatment strategies to prevent or relieve symptoms associated with hip instability, using the validated Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD ) questionnaire as the primary outcome measure of health-related quality of life © (HRQL) for this population. 650 patients enrolled from 28 sites in 11 countries, are actively being followed and will reach at least 2 years of follow-up at the end of 2019. This project, will study the impact of hip instability and its management in children with severe CP using the CPCHILD questionnaire that was developed specifically for this purpose. Although CHOP will define outcomes at 24 months, the outcomes are not expected to remain stable while the child is still growing. The inception cohort will need follow-up until skeletal maturity to track their long-term outcome trajectories.

A vizsgálat 5 csoportja

• "Natural" History or watchful waiting
• Serial botulinum toxin injections
• Adductor (+/- psoas) muscle releases alone
• Hip reconstructive surgery
• Salvage hip surgery