Article

Children with severe forms of cerebral palsy (CP) are at high risk of hip
joint displacement. Various studies have found that the pain from affected joints
occurs in 40 to 84% of studied individuals. The purpose of this study was to
establish a correlation between the density of nociceptors localized in selected
areas of the spastic dislocated hip joint and clinical evidence of hip joint pain
in children with CP. METHOD: Nineteen samples of articular capsule and 19 samples
of teres ligaments, collected during open hip joint reduction from 19
non-ambulatory children with spastic CP (Gross Motor Function Classification
System level V; mean age 9y 6mo; 10 males, nine females), were studied. Pain was
assessed using the numeric rating scale completed by caregivers. The density of
nociceptive fibres was compared between the children with painful and children
with painless hip joints, using S-100 and substance P monoclonal antibodies.
RESULTS: The presence of S-100 protein and substance P were significantly
increased (p=0.024 and p=0.02 respectively) in the children with painful hip
joints. There were significantly positive correlations between the intensity of
pain and the density of nerve fibres with S-100 protein (teres ligament, p=0.001;
joint capsule, p=0.032) as well as substance P (teres ligament, p=0.001).
INTERPRETATION: Direct and indirect inflammatory factors, present in dislocated
hip joints with cartilage damage in children with spastic CP, lead to hip joint
sensitization.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2011 Mac Keith
Press.

Langue : ANGLAIS