Functionality Against Odds: Lower Extremity Function Score and Children Health Assessment Questionnaire in Children with Bilateral Septic Sequelae of Hip

Purpose: We assessed the functional and radiological outcomes of children with sequelae of bilateral septic hips. Additionally, we attempted to determine the impact of radiological unstable hips on clinical functionality of the child. Material and methods: The retrospective case series included 9 children minimum 2 years post infection. The functional outcomes were assessed using Lower Extremity Function Score (LEFS) and Children Health Assessment Questionnaire (CHAQ). Follow up hip radiographs were classified according to the Choi’s classification. We labelled the patient as having instability if either hip had a Choi type >3A. Results: The mean age at final follow-up was 7.6 years. Five patients had multiple joints affection. The mean LEFS score was 62.7 and CHAQ-DI 0.2. The mean LEFS values for radiological stable hips (n= 5 patients) was 66 ± 19.4 and 58.5 ± 15.3 for unstable hips (p=0.5487) while corresponding CHAQ-DI scores were 0.12 ± 0.13 and 0.27 ± 0.12 respectively (p=0.1098) indicating poor relatability between functional capabilities of the child and the radiological appearances of the hips. A strong negative correlation however existed between LEFS/ CHAQ-DI values (R= -0.897; p=0.001). Conclusions: Septic hip sequelae in children leads to various degrees of functional limitations and patients with multiple joint involvement have worse outcomes. The hip radiological findings do not relate with the overall functional status of the child. Keywords: Functional outcome, Disability, Hip, Sepsis, Child