British Columbia CP Hip Survelliance
The Child Health BC Hip Surveillance Program for Children with Cerebral Palsy is the first province- or state-wide hip surveillance program of its kind in North America. The program launched in 2016.
Hip Surveillance
The process of monitoring and identifying the critical early indicators of hip displacement. If hip displacement is not identified and acted upon early, complex and significant surgery can be required.
Objectives
1. Ensure that children at risk for hip displacement receive appropriate screening to allow for early and appropriate management.
2. Facilitate the implementation of the recommended standard of care for hip surveillance into practice across the province.
Population
Pediatric population (age ≤19 years)
Children diagnosed with cerebral palsy
Children not yet diagnosed with CP but for whom there is a clinical suspicion of having CP
Salvage Surgeries
If caught early, there are non-surgical options such as botox and bracing to help prevent further hip displacement, or surgical options such as soft tissue releases and reconstructive hip surgery. However, when hip displacement is identified at its late stages, the head of the femur may have already changed shape. When this happens reconstructive surgery is no longer possible and a salvage surgery may be the only option. With salvage surgery the hip joint cannot be reconstructed and the goals are to decrease pain and improve comfort.
Change in Surgical Practice
During an 18-month period in 2008 and 2009, 35% of hip surgeries were salvage procedures.
In 2014, 15% of hip surgeries performed were salvage procedure. By 2018, less than 4% of procedures were salvage; all of these were for existing patients or refugees and immigrants new to BC.