Southampton surgeons lead hip screening programme

Southampton Children’s Hospital is leading the development of a hip screening programme for children with neuromuscular disorders to reduce the need for surgery.

There is not currently a standard programme of its kind in England, although hip surveillance programmes were first established in Scotland three years ago. The surgeons at Southampton Children’s Hospital now hope to create a standard model that can be rolled out nationwide by developing an electronic database of patients screened in southern England – known as the Cerebral Palsy Integrated Pathway, Southern England (CPIPSE).

The screening programme will specifically involve children with cerebral palsy, a brain disorder that can cause the muscles to tighten and pull the hip joint out of place or lead to dislocation. The condition affects around one in 500 people in the UK, with displacement or dislocation occurring in 60 per cent of children who are not walking by the age of five.

A standardised surveillance programme enables earlier detection of movement in the hips, with evidence from the programme in Scotland showing that the proportion of children with cerebral palsy requiring surgery to treat their musculoskeletal deformity decreasing from 40 per cent to 15 per cent.

Alex Aarvold, project lead at the hospital, said: “Hip displacement or dislocation can have a major impact on a child’s life, including pain, deformity, limited mobility and an inability to carry out normal everyday activities. Yet we know there is progressive movement in the hip to full dislocation in patients with cerebral palsy and other neuromuscular disorders and movement can be easily quantified on a hip radiograph, which is inexpensive and simple to perform. As a result, it seems nonsensical to not have a standard programme in place nationwide to manage this group effectively.”

Caroline Edwards, clinical lead for orthopaedics at Southampton Children’s Hospital, added: “This project will help to identify the volume of cerebral palsy patients in the community that have not been included in recommended hip surveillance programmes.”