CHBC Hip Surveillance Program For Children With Cerebral Palsy

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Overview

The Child Health BC Hip Surveillance Program for Children with Cerebral Palsy is the first province wide hip surveillance program of its kind in Canada. After site testing in 2015, the program launched throughout BC in 2016. 

The Child Health BC Hip Surveillance Program for Children with Cerebral palsy aims to:

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. 

Hip Surveillance Overview Video

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What is Hip Surveillance?


Hip surveillance is the process of monitoring for hip displacement through regular clinical exams and radiographs (x-rays). Hip displacement is a common problem in children with cerebral palsy. With increasing hip displacement, children can experience pain, decreased quality of life, and degenerative changes. If not identified and acted upon early, the need for a complex and significant surgery can result, even leading to the need to remove the hip joint (salvage surgery) in the most severe situations. Research has shown that careful, planned tracking, otherwise known as surveillance, together with timely orthopaedic surgery, can prevent or reduce the need for these salvage surgeries.


How does Hip Surveillance work in BC?
 

Surveillance occurs in the child’s home community. The program is managed at BC Children’s Hospital by a Medical Lead, an orthopaedic surgeon, and Coordinator, a physical therapist, who work together with the child’s local healthcare team. At standardized intervals, based on the child’s level of risk for hip displacement, a child has a clinical exam completed, typically by their physical therapist, where hip motion, pain, and motor function are assessed. When recommended, an x-ray is ordered by the Hip Surveillance program team and is completed at the child’s local hospital or healthcare centre. Results of surveillance are communicated back to the child’s family and local healthcare team, including recommendations for ongoing surveillance or the need to see a pediatric orthopaedic surgeon for a more detailed assessment of the hip. 

How was the program developed?


The program is based on BC's Consensus on Hip Surveillance for Children with Cerebral Palsy. This Consensus was originally developed collaboratively by a multi-disciplinary group of professionals and parents, representing all regions of the province, based on the best available research evidence while being mindful of the provincial needs and setting. The group subsequently developed a plan for implementation which met the needs of BC’s vast geography and mix of metro, urban, rural, and remote populations. The approach to develop the provincial consensus statement and the implementation of the consensus is outlined in meeting reports from  2011 and 2012. In 2018, BC’s Consensus was updated to reflect international consensus achieved in the development of the American Academy of Cerebral Palsy and Developmental Medicine Hip Surveillance Care Pathway (Quick Guide).

Information resources for professionals and families are available. To enroll a child, please complete the Enrollment Package.  A physician’s referral is not required.

Our online learning module supports the implementation of the Child Health BC Hip Surveillance Program for Children with Cerebral Palsy. It is intended for physical therapists, occupational therapists, physicians, and all other health care professionals working with children with cerebral palsy. Work through this 45 minute learning module at your own pace by starting and stopping, as needed.   
 
For more information, contact:

Stacey Miller, MRSc, BSc(PT)
Child Health BC Hip Surveillance Program Coordinator 
Room 1D.62, 4480 Oak Street
Vancouver, BC
V6H 3V5 
604-875-2345 extension 4099 or 1-888-300-3088 extension 4099 
Email: hips@cw.bc.ca 
 
Dr. Kishore Mulpuri, MBBS, MS (Ortho), MHSC (Epi)
Child Health BC Hip Surveillance Program Medical Lead
Pediatric Orthopaedic Surgeon
Associate Professor, Department of Orthopaedics, University of British Columbia 
Room 1D.66, 4480 Oak Street
Vancouver, BC, V6H 3V5
T: 604-875-2054 or 1-888-300-3088 extension 2054
F: 604-875-2275 
Email: hips@cw.bc.ca

The Child Health BC Hip Surveillance Program for Children With Cerebral Palsy collects personal information only as authorized under section 26 (c) of the BC Freedom of Information and Protection of Privacy Act and other legislation. Information is collected for the purposes of completing on-going monitoring of hip displacement. We take all reasonable steps to make sure personal information is treated confidentially, is used only for the intended purpose and securely stored. For questions regarding collection, use or disclosure of your child’s personal information, please contact the Hip Surveillance Program Coordinator at (604) 875-2345 extension 4099 or business address: BC Children’s Hospital, Child Health BC Hip Surveillance Program, Orthopaedics, 4480 Oak Street, Room 1D62, Vancouver, BC V6H 3V4.