Prevention of hip displacement in children with cerebral palsy: a systematic review

Aim To conduct a systematic review and evaluate the quality of evidence for interventions to prevent hip displacement in children with cerebral palsy (CP). Method A systematic review was performed using American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) and Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) methodology. Searches were completed in seven electronic databases. Studies were included if participants had CP and the effectiveness of the intervention was reported using a radiological measure. Results of orthopaedic surgical interventions were excluded. Results Twenty‐four studies fulfilled the inclusion criteria (4 botulinum neurotoxin A; 2 botulinum neurotoxin A and bracing; 1 complementary and alternative medicine; 1 intrathecal baclofen; 1 obturator nerve block; 8 positioning; 7 selective dorsal rhizotomy). There was significant variability in treatment dosages, participant characteristics, and duration of follow‐up among the studies. Overall, the level of evidence was low. No intervention in this review demonstrated a large treatment effect on hip displacement. Interpretation The level and quality of evidence for all interventions aimed at slowing or preventing hip displacement is low. There is currently insufficient evidence to support or refute the use of the identified interventions to prevent hip displacement or dislocation in children and young people with CP. What this paper adds High‐quality evidence on prevention of hip displacement is lacking. No recommendations can be made for preventing hip displacement in children with cerebral palsy because of poor‐quality evidence. High‐quality, prospective, longitudinal studies investigating the impact of interventions on hip displacement are required. Resumen Prevención de la displasia de cadera en niños con parálisis cerebral: revisión sistemática Objetivo presentar una revisión sistemática y evaluar la calidad de la evidencia en intervenciones para prevenir el desplazamiento de la cadera en niños con parálisis cerebral (PC). Método se realizo una revisión sistemática basándose en la metodología de la American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) y Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA). Se realizaron búsquedas en siete base de datos, los estudios fueron incluidos si los participantes tenían PC y la eficacia de la intervención fue realizada utilizando medición radiográfica. Fueron excluid