Australian Hip Surveillance Guidelines
Children with cerebral palsy are at risk of developing progressive hip displacement. Every child should be referred for hip surveillance at the time cerebral palsy is identified.
Early detection is an essential part of the strategy for prevention of further hip displacement, hip dislocation and its sequelae of pain, reduced function and decreased quality of life. ‘Hip surveillance’ is the process of identifying and monitoring the critical early indicators of hip displacement.
The Australian Hip Surveillance Guidelines for children with Cerebral Palsy (2020) document the recommended process for screening, monitoring and triaging to orthopaedic services as part of the overall prevention of hip dislocation.
Download the guidelines
Two documents are available to guide health professional in implementing hip surveillance:
Guideline review and endorsement
The Australian Hip Surveillance Guidelines for Children with Cerebral Palsy aim to provide evidence-based guidance for clinical decision making related to the commencement, frequency and cessation of hip surveillance, and to guide timely triage and referral for individual orthopaedic assessment and management. They are also a tool for the information and education of all health professionals working with children with CP and their families.
The guidelines are based on the key principles of:
- Early identification of displacement to facilitate early intervention
- Standardisation of monitoring programs
- Balancing risk and benefit: reducing radiation exposure for children in lower risk categories and
- Screening and stratification techniques based on risk factors to facilitate efficiencies of health service use
The ‘Consensus Statement on Hip Surveillance for Children with Cerebral Palsy: Australian Standards of Care’, 2008 (Standards of Care) (Wynter, et al., 2011) was developed by a literature review and a formal external consensus process. At the time of development, it was recognised that ongoing, regular review of the Standards of Care should be undertaken to consider the impact of new evidence, and a process of 5 yearly review was established. In 2013 a National Working Group undertook a systematic literature review following PRISMA guidelines, a national survey of orthopaedic surgeons working with children with CP, and analysis of data from state-based hip surveillance databases. This review informed the revised and renamed Australian Hip Surveillance Guidelines for Children with CP: 2014 (Wynter et al., 2015). Review of the 2014 Guidelines commenced in 2019 with an updated systematic review and evaluation of the guidelines using the AGREE II methodological framework for the development of clinical guidelines. The Victorian Hip Surveillance Consumer Advisory Committee, comprising of parents of young people with CP, was consulted regarding the proposed changes to the Guidelines.
The results of this comprehensive review process form the basis for the Australian Hip Surveillance Guidelines for Children with Cerebral Palsy: 2020.
The guidelines will be reviewed in 2025.
- Wynter M; Gibson N; Kentish M; Love S; Thomason P; Graham HK. The Consensus Statement on Hip Surveillance for Children with Cerebral Palsy: Australian Standards of Care. J Pediatr Rehab Medicine. 2011; 4(3):183-95
- Wynter M, Gibson, N, Willoughby KL, Love S, Kentish M, Thomason P, Graham HK. Australian hip surveillance guidelines for children with cerebral palsy: five year review. Dev Med Child Neurol 2015; 57:808-820.