Patients with cerebral palsy (CP) are at increased risk for osteoporosis and osteoarthritis compared with patients who do not have CP, according to study results published in Bone.
It is widely accepted that patients with CP are at a greater risk for musculoskeletal disorders, but high-quality evidence is lacking to measure how significant the risk is. To better understand this association, researchers conducted a study of participants with CP (n = 1705; median age, 29 years) who were matched 1:3 with controls for age, sex, and general practice (n = 5115; median age, 29 years) from the Clinical Practice Research Datalink between 1987 and 2015. Participants were followed until a transfer out of the Clinical Practice Research Datalink, end of the study period, last collection date, death, or a clinical diagnosis of osteoarthritis, osteoporosis, or inflammatory musculoskeletal disease.
The researchers used Cox models to compare the risk for osteoporosis, osteoarthritis, and inflammatory musculoskeletal diseases after stratifying by matched sets and adjusting for potential confounders.
The researchers found that participants with CP had an increased risk for osteoporosis compared with controls in both unadjusted (hazard ratio [HR], 3.67; 95% CI, 2.32-5.80; P <.001) and adjusted analyses (HR, 6.19; 95% CI, 3.37-11.39; P <.001).
In unadjusted analysis, the researchers did not find that participants with CP had an increased risk for osteoarthritis compared with controls. However, there was evidence of increased risk after adjusting for alcohol consumption, smoking status, and mean yearly general practice visits (HR, 1.54; 95% CI, 1.17-2.02; P =.002).
The results did not indicate that participants with CP had increased risk for inflammatory musculoskeletal diseases compared with controls in either unadjusted or adjusted analyses.
“These findings support the need for clinical awareness of [osteoarthritis] and [osteoporosis] as potential comorbidities in adults with CP,” the researchers wrote.
O’Connell NE, Smith KJ, Peterson MD, et al. Incidence of osteoarthritis, osteoporosis and inflammatory musculoskeletal diseases in adults with cerebral palsy: a population-based cohort study. Bone. 2019;125:30-35.