Marcström Alexander, Hägglund Gunnar, Alriksson-Schmidt Ann I
Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Orthopedics, Lund, Sweden.
BMC Musculoskelet Disord. 2019 Feb 8;20(1):62. doi: 10.1186/s12891-019-2449-8.
Hip pain is prevalent in children with cerebral palsy (CP). Hip displacement is a known risk factor for hip pain. However, many children do not have displaced hips but still have hip pain and the aetiologies are poorly understood. The aims of this study were to investigate: 1. the prevalence of hip pain related to age, gender, gross motor function, degree of hip displacement and 2. the associations between hip pain and age, gender, gross motor function, degree of hip displacement, ranges of hip and knee motion (ROM) and degree of spasticity in the muscles around the hip.
This was a cross-sectional retrospective register study based on data from the Swedish follow-up programme and national healthcare registry CPUP, which includes > 95% of children with CP in Sweden. The participants were born in 2000 or later and 4-16 years of age. Data from the latest examination were used. In Aim 1, the prevalence of hip pain was calculated using frequencies and crosstabs. Differences between groups were calculated using chi-square tests and independent samples t-tests. In Aim 2, associations between hip pain and the variables were analysed using logistic regression.
The overall prevalence of hip pain was 7%. No significant gender difference was found. Hip pain prevalence increased with age, lower gross motor function and higher degree of hip displacement. The median migration percentage (MP) in painful hips was 26%, compared to 21% in hips where pain was not reported. In the multivariable analysis, significant associations with hip pain were found for MP > 30% and decreased ROM in abduction, flexion and inwards rotation of the hip (p < 0.05).
Hip displacement was associated with hip pain. However, hip displacement was not present in the majority of painful hips. In addition to hip displacement, decreased ROM was also associated with hip pain.
髋关节疼痛在脑瘫（CP）儿童中很常见。髋关节移位是已知的髋关节疼痛风险因素。然而，许多儿童髋关节并未移位，但仍存在髋关节疼痛，其病因尚不清楚。本研究的目的是调查：1. 与年龄、性别、粗大运动功能、髋关节移位程度相关的髋关节疼痛患病率；2. 髋关节疼痛与年龄、性别、粗大运动功能、髋关节移位程度、髋关节和膝关节活动范围（ROM）以及髋关节周围肌肉痉挛程度之间的关联。
这是一项基于瑞典随访计划和国家医疗保健登记处CPUP数据的横断面回顾性登记研究，该登记处涵盖了瑞典95%以上的脑瘫儿童。参与者出生于2000年或之后，年龄在4至16岁之间。使用最新检查的数据。在目标1中，使用频率和交叉表计算髋关节疼痛的患病率。使用卡方检验和独立样本t检验计算组间差异。在目标2中，使用逻辑回归分析髋关节疼痛与变量之间的关联。
髋关节疼痛的总体患病率为7%。未发现显著的性别差异。髋关节疼痛患病率随年龄增长、粗大运动功能降低和髋关节移位程度增加而升高。疼痛髋关节的中位移位百分比（MP）为26%，而未报告疼痛的髋关节为21%。在多变量分析中，发现MP>30%以及髋关节外展、屈曲和内旋的ROM降低与髋关节疼痛存在显著关联（p<0.05）。
髋关节移位与髋关节疼痛相关。然而，大多数疼痛的髋关节并未出现移位。除髋关节移位外，ROM降低也与髋关节疼痛相关。
