Botox and Partial Hip Dislocation

The risk of partial hip dislocation (hip subluxation), leading to complete dislocation, is a serious problem in children with CP, and can occur in children with CP as early as 18 months. If you have a child with CP, chances are your physician has already suggested your child be checked for partial hip dislocation. (If the hip has not begun to dislocate before the age of 4 or 5, then the chances are good the hip will remain normal.)

To date, braces and similar approaches have been used to prevent this problem. However, researchers are now studying Botox injection as a potential means of preventing partial dislocation. One of those studies was undertaken with 16 patients (aged 9-43 months) to see if x-rays taken before and after Botox injections would prove the injections helpful in preventing partial hip dislocation. Patients were to wear braces at night as part of the program, although there was no way to actually verify that the children did, in fact, wear their braces.

The conclusion? The overall change on x-rays was found to be significant only in patients in the younger age group, and was statistically insignificant in the older age groups. The authors concluded that Botox may be beneficial for some patients (while noting the small number of patients studied), and suggested further studies be done to look at the combined effects of bracing, antispasmodic medication, and Botox over a longer period of time. For now, the authors concluded each child should be considered on an individual basis for this type of treatment.

For more information: “Hip migration percentage in children with cerebral palsy treated with botulinum toxin type A,” F. Pidcock, MDa; D. Fish, Md, MPHb; D. Johnson-Greene, PhD, ABPPa; I. Boras, aMDc; J. McGready, MSd; C. Silberstein, MDe; Archives of Physical Medicine and Rehabilitation, vol. 86, no. 3, p. 431-435, March 2005.