Brace may prevent further hip displacement in children with non-ambulatory cerebral palsy

Published results showed use of a novel hip brace was effective for preventing progression of hip displacement and improving quality of life in patients with nonambulatory cerebral palsy.

My Baby’s Hip Dysplasia. Coping with my baby’s hip dysplasia wasn’t easy at first! She was x-rayed when she was exactly 4 months old. Two days later our GP called & referred us to the hospital pediatric department. The doctor looked at the x-ray and said our daughter has severe hip dysplasia. Becky O’Haire Cuddle Fairy

By Max R. Wursta, Fact checked by Gina Brockenbrough, MA, Healio Orthopedics November 4, 2022

In a prospective, single-blinded randomized clinical trial, Bo Ryun Kim, MD, PhD, and colleagues tested the efficacy of a novel hip brace for the prevention of hip displacement in 66 children with cerebral palsy (gross motor function classification system level 4 or 5). According to the study, the brace was developed for research and approved by the South Korean Ministry of Food and Drug Safety as a class 1 medical device.

Researchers randomized 33 patients (mean age of 68.7 months) to wear the hip brace, designed to compresses the capsule and ligaments around the hip where displacement occurs, for a minimum of 12 hours per day for 1 year. The other 33 patients (mean age of 60.7 months) were randomized to a control group with no bracing. Both cohorts received conventional physical therapy for the duration of the 1-year study period. Outcome measures were assessed at 6-month and 1-year follow-ups and included the Reimers migration index (MI) on radiographs, as well as quality of life (QoL) scores.

At baseline, mean MI was 37.4% in the bracing group and 30.6% in the control group. At 1 year, mean MI decreased to 34.6% in the bracing group and increased to 40.1% in the control group. Mean difference of MI in the bracing group vs. the control group was 8.7 percentage points at 6 months and 12.7 percentage points at 1 year. Additionally, researchers noted QoL scores reached a “statistically significant” improvement in the bracing group compared with the control group at 6 months.

“[The brace] effectively slowed and improved displacement and improved QoL in patients with cerebral palsy,” Kim and colleagues wrote in the study. “Therefore, brace use could comprise a promising treatment method to delay hip surgery in patients with cerebral palsy.”

Disclosures

Kim reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

Source Healio Orthopedics

References

Efficacy of a Hip Brace for Hip Displacement in Children With Cerebral Palsy: A Randomized Clinical Trial, Bo Ryun Kim MD PhD, Jin A. Yoon MD PhD, Hyun Jung Han PhD, Young Il Yoon PhD, Jiwoon Lim MD, Seungeun Lee MS, Seon Cho BS, Yong Beom Shin MD PhD, Hyun Jung Lee PhD, Jee Hyun Suh MD PhD, Joonyoung Jang MD, Jaewon Beom MD PhD, Yulhyun Park MD, Jung-Hwa Choi MD, Ju Seok Ryu MD PhD. JAMA Netw Open. 2022;5(11):e2240383. doi:10.1001/jamanetworkopen.2022.40383. Full text