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Functional status and amount of hip displacement independently affect acetabular dysplasia in cerebral palsy.

Functional status and amount of hip displacement independently affect acetabular dysplasia in cerebral palsy.
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Chung MK, Zulkarnain A, Lee JB, Cho BC, Chung CY, Lee KM, Sung KH, Park MS,


Chung MK, Zulkarnain A, Lee JB, Cho BC, Chung CY, Lee KM, Sung KH, Park MS, (click to view)

Chung MK, Zulkarnain A, Lee JB, Cho BC, Chung CY, Lee KM, Sung KH, Park MS,

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Developmental medicine and child neurology 2017 04 2259(7) 743-749 doi 10.1111/dmcn.13437
Abstract
AIM
Acetabular dysplasia is the one of main causes of hip displacement in patients with cerebral palsy (CP). Although several studies have shown a relationship between hip displacement and acetabular dysplasia, relatively few have evaluated the association between quantitative acetabular dysplasia and related factors, such as Gross Motor Function Classification System (GMFCS) level.

METHOD
We performed a morphometric analysis of the acetabulum in patients with CP using multiplanar reformation of computed tomography data. The three directional acetabular indices (anterosuperior, superolateral, and posterosuperior) were used to evaluate acetabular dysplasia. Consequently, linear mixed-effects models were used to adjust for related factors such as age, sex, GMFCS level, and migration percentage.

RESULTS
A total of 176 patients (mean age 9y 5mo, range 2y 4mo-19y 6mo; 104 males, 72 females) with CP and 55 typically developing individuals (mean age 13y 6mo, range 2y 5mo-19y 10mo; 37 males, 18 females) in a comparison group were enrolled in this study. Statistical modelling showed that all three directional acetabular indices independently increased with GMFCS level (p<0.001) and migration percentage (p<0.001). INTERPRETATION
Acetabular dysplasia was independently affected by both the amount of hip displacement and the GMFCS level. Thus, physicians should consider not only the migration percentage but also three-dimensional evaluation in patients at high GMFCS levels.

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