| Title: |
Do Adductor Tenotomies Prevent Progressive Migration in Children with Cerebral Palsy? ; A Systematic Review |
| Authors: |
van Stralen, Renée Anne; Roelen, Merel Charlotte Rosalie; Buddhdev, Pranai; Reijman, Max; Eygendaal, Denise; Tolk, Jaap Johannes |
| Source: |
JBJS Reviews ; volume 12, issue 8 ; ISSN 2329-9185 |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2024 |
| Description: |
Background: Up to one-third of children with cerebral palsy (CP) develop migration of the hip, and the risk increases with a higher Gross Motor Function Classification System (GMFCS). In progressive hip migration in young children, adductor tenotomy is an accepted treatment option to delay or prevent progressive hip migration. However, there is quite a large variability in reported results. This systematic review aims to determine the effectiveness of a soft-tissue release in the prevention of progressive hip migration in children with CP. Methods: This systematic review was performed in accordance with the guidelines of the Cochrane Handbook for Systematic Reviews and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statements. Our inclusion criteria were studies describing pediatric, skeletally immature patients with CP and a “hip at risk” of progressive hip migration. Exclusion criteria were simultaneous bony reconstructions, case reports, technical notes, published abstracts, or studies with a follow-up under 1 year postoperatively. The primary outcomes were defined as failure rate (progressive hip migration and/or need for bony surgery, as defined by each paper) and change in migration percentage (MP) at final follow-up. As secondary analyses, we evaluated the outcome after specific subtypes of surgeries and assessed whether performing lengthening of iliopsoas, neurectomy of the anterior branch of the obturator nerve, age at the time of surgery, GMFCS level, and postoperative management impact the outcome. Results: Our literature search identified 380 titles. Eighty-four articles underwent full-text review, of which 27 met our inclusion/exclusion criteria and were subsequently selected for quantitative analysis. A prevalence meta-analysis was performed including 17 studies (2,213 hips). Mean follow-up ranged from 12 to 148.8 months. The mean preoperative MP was 33.4% (2,740 hips) and 29.9% at follow-up. The overall reported failure rate was 39% (95% confidence interval, ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.2106/jbjs.rvw.24.00093 |
| DOI: |
10.2106/JBJS.RVW.24.00093 |
| Availability: |
https://doi.org/10.2106/jbjs.rvw.24.00093; https://journals.lww.com/10.2106/JBJS.RVW.24.00093 |
| Rights: |
http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.F2927DB9 |
| Database: |
BASE |