Evidence map›Paper›PMID 41770043›Full record

SynthesisEFORT open reviews2026

The approach to hip instability in children with cerebral palsy: an umbrella review.

Ana Paula Tedesco, Alessandro Melanda, Davi Moshe, Epitácio Rolim Filho, Francesco Camara Blumetti, Leonardo Cury Abrahão, Mauro César de Morais Filho, Patricia Moreno Grangeiro

Abstract readSystematic Review
In one paragraph

Synthesis in EFORT open reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. [Osteotomies of the pediatric hip joint].Orthopadie (Heidelberg, Germany) · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ana Paula TedescoInstituto de Neuro-Ortopedia, Caxias do Sul, RS, Brazil.
Alessandro MelandaUniversidade Estadual de Londrina - Paraná, Instituto Pró-Kids de Londrina, Londrina, PR, Brazil.
Davi MosheUniversidade Federal do Ceará, Fortaleza, CE, Brazil.
Epitácio Rolim FilhoDepartamento de Ortopedia da UFPE, Hospital Getúlio Vargas, AACD, Recife, PE, Brazil.
Francesco Camara BlumettiHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Leonardo Cury AbrahãoOrtopédico BH; AMR; Hospital da Baleia, Belo Horizonte, MG, Brazil.
Mauro César de Morais FilhoAACD - Associação de Assistência à Criança Deficiente, São Paulo, SP, Brazil.
Patricia Moreno GrangeiroCentro Integrado de Neuro-Ortopedia, Instituto de Ortopedia e Traumatologia, HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil.ORCID https://orcid.org/0000-0002-1533-659X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Children with cerebral palsy (CP) are at a high risk of progressive hip displacement, defined as lateral migration of the femoral head measured by the Reimers migration percentage. This condition may impair quality of life, highlighting the need for improved hip care. This umbrella review assessed current evidence on the evaluation, prevention, and treatment of hip displacement in children with CP by synthesizing systematic reviews. Methods: Systematic reviews published in English between 2004 and 2024 were included, focusing on children with CP aged 0-18 years. Searches were conducted in nine databases: PubMed, MEDLINE, Web of Science, Scopus, BVS, CINAHL, Cochrane Library, PEDro, LILACS, and EMBASE. Methodological quality was assessed using AMSTAR 2 for interventional studies and JBI criteria for non-interventional studies. This review has been registered at PROSPERO (registration number: CRD42024618645). Results: In total, 25 systematic reviews addressed key aspects of hip management, including hip surveillance; tone management; preventive, reconstructive, and salvage procedures; and antifibrinolytic use. Hip surveillance reduced hip dislocation rates and the need for salvage surgery, whereas postural and tone management showed no consistent preventive effect. Combined pelvic and femoral osteotomies achieved better outcomes than isolated procedures, while soft-tissue surgeries had high recurrence rates. Proximal femoral hemiepiphysiodesis improved radiographic outcomes but frequently required revision. Salvage procedures such as valgus osteotomy and femoral head resection relieved pain, whereas hip arthrodesis showed poor outcomes. Total hip arthroplasty improved pain and function but was associated with high complication rates. Conclusions: This umbrella review highlights evidence-based practices and important knowledge gaps in the management of hip instability in children with CP, supporting future research and improved clinical care.

Indexed as

cerebral palsyguidelineship instabilitysurveillanceumbrella review

Identifiers

PMID41770043
PMCPMC12974736

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.