SICOT-J最新文献

{"title":"Management of fixed flexion contracture in primary total knee arthroplasty: recent systematic review.","authors":"Elliot Sappey-Marinier, Andréa Fernandez, Jobe Shatrov, Cécile Batailler, Elvire Servien, Denis Huten, Sébastien Lustig","doi":"10.1051/sicotj/2024007","DOIUrl":"10.1051/sicotj/2024007","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to systematically review the literature and identify the surgical management strategy for fixed flexion contracture in primary total knee arthroplasty (TKA) surgery, pre-, intra-, and post-operatively. Secondary endpoints were etiologies and factors favoring flexion contracture.</p><p><strong>Materials and methods: </strong>Searches were carried out in November 2023 in several databases (Pubmed, Scopus, Cochrane, and Google Scholar) using the following keywords: \"flexion contracture AND TKA\", \"fixed flexion deformity AND TKA\", \"posterior capsular release AND TKA\", \"posterior capsulotomy in TKA\", \"distal femoral resection AND TKA\". Study quality was assessed using the STROBE checklist and the Downs and Black score. Data concerning factors or strategies leading to the development or prevention of flexion contracture after TKA were extracted from the text, figures, and tables of the included references. The effect of each predictive factor on flexion contracture after TKA was recorded.</p><p><strong>Results: </strong>Thirty-one studies were identified to meet the inclusion and exclusion criteria. These studies described a variety of preoperative and intraoperative factors that contribute to the development or correction of postoperative flexion contracture. The only clearly identified predictor of postoperative flexion contracture was preoperative flexion contracture. Intraoperative steps described to correct flexion contracture were: soft-tissue balancing (in posterior and medial compartments), distal femoral resection, flexion of the femoral component, and posterior condylar resection. However, no study has investigated these factors in a global model.</p><p><strong>Discussion: </strong>This review identified various pre-, intra-, and post-operative factors predictive of post-operative flexion contracture. In practice, these factors are likely to interact, and it is therefore crucial to further investigate them in a comprehensive model to develop an algorithm for the management of flexion contracture.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"11"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10964851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining inertial navigation with transacetabular ligament in total hip arthroplasty via direct anterior approach results in excellent accuracy compared to standard manual technique - A retrospective cohort study.","authors":"Vincent Maes, David Cossetto","doi":"10.1051/sicotj/2024013","DOIUrl":"https://doi.org/10.1051/sicotj/2024013","url":null,"abstract":"<p><strong>Background: </strong>Correct acetabular component placement plays a critical role in reducing early revisions after dislocations in total hip arthroplasty (THA). Although the transverse acetabular ligament (TAL) guides anteversion, inclination can only be accurately guided by navigation. In order to overcome the initial disadvantages with navigation, an imageless, easy-to-use inertial navigation system has been recently introduced. This study aims to analyze the accuracy of inclination with this navigation system compared to the standard manual technique.</p><p><strong>Methods: </strong>Two cohorts, manual technique (MT) and navigation (NAV) cohorts, consisted of 83 and 95 patients, respectively, after exclusion criteria were applied. Inclination target was 38° and anteversion was guided by TAL. Demographic data were collected, and anteroposterior (AP) pelvic and cross-table lateral radiographs were obtained 6 weeks post-operatively. Inclination and anteversion were determined on the AP pelvic and cross-table lateral radiograph, respectively.</p><p><strong>Results: </strong>A mean inclination of 41.8° (±6.8°) and 38.9° (±4.4°) was found in the MT and NAV cohorts, respectively. There was no statistical difference in gender, age, and BMI. If the inclination was set within 10° of the target (i.e., 38°), 88% of the MT cohort and 97% of the NAV cohort were within the target zone. Accuracy decreased to 53% and 83%, respectively, if the target zone range was narrowed down to ± 5°.</p><p><strong>Conclusion: </strong>Combining inertial imageless navigation for inclination and TAL as a landmark for anteversion is significantly more accurate compared to the manual technique, without having the limitations and disadvantages of current standard navigational techniques.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"16"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11101203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in planned orthopaedic care.","authors":"Elena Chiara Thalia Georgiakakis, Akib Majed Khan, Kartik Logishetty, Khaled Maher Sarraf","doi":"10.1051/sicotj/2024044","DOIUrl":"10.1051/sicotj/2024044","url":null,"abstract":"<p><p>The integration of artificial intelligence (AI) into orthopaedic care has gained considerable interest in recent years, evidenced by the growing body of literature boasting wide-ranging applications across the perioperative setting. This includes automated diagnostic imaging, clinical decision-making tools, optimisation of implant design, robotic surgery, and remote patient monitoring. Collectively, these advances propose to enhance patient care and improve system efficiency. Musculoskeletal pathologies represent the most significant contributor to global disability, with roughly 1.71 billion people afflicted, leading to an increasing volume of patients awaiting planned orthopaedic surgeries. This has exerted a considerable strain on healthcare systems globally, compounded by both the COVID-19 pandemic and the effects of an ageing population. Subsequently, patients face prolonged waiting times for surgery, with further deterioration and potentially poorer outcomes as a result. Furthermore, incorporating AI technologies into clinical practice could provide a means of addressing current and future service demands. This review aims to present a clear overview of AI applications across preoperative, intraoperative, and postoperative stages to elucidate its potential to transform planned orthopaedic care.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"49"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Afternoon kick-off, evening kick-off, or night kick-off in the first German Bundesliga - A possible Injury risk factor?","authors":"Erik Schiffner, Dominique Schoeps, Christos Koukos, Felix Lakomek, Joachim Windolf, David Latz","doi":"10.1051/sicotj/2024049","DOIUrl":"10.1051/sicotj/2024049","url":null,"abstract":"<p><strong>Introduction: </strong>This retrospective cohort study aimed to evaluate the impact of kick-off time on the risk of injury for professional soccer players in the first German Bundesliga. It was hypothesized that late kick-off times would have a negative effect on muscle and ligament injuries to the ankle and knee.</p><p><strong>Methods: </strong>Kick-off times and injury data were collected over 5 consecutive seasons (1530 matches; 2014-2019) from two media-based registries (transfermarkt.de^® und kicker.de^®). The kick-off times were assorted into three groups: Afternoon kick-off between prior to 3:30 pm (988 matches), evening kick-off between 5:30 to 6:30 pm (303 matches), and night kick-off after 8 pm (239 matches).</p><p><strong>Results: </strong>A total of 1327 match injuries were recorded over 5 seasons in 510 different male elite soccer players. The injuries affected muscles in 32.1%, ankle ligaments in 7.8%, and knee ligaments in 5.6%. There was no significant difference in injury rates when comparing different kick-off time groups (p > 0.05), however, the mean of time attributed to muscle and ankle ligament injuries suffered in games with a late kick-off time was significantly longer (p < 0.05).</p><p><strong>Conclusion: </strong>This study shows that there is no significant (p > 0.05) association between three different kick-off time groups and injury risk in the first German Bundesliga. However, significant (p < 0.05) differences in the lay-off times attributed to muscle and ankle ligament injuries differed with different kick-off times assorted into the three groups. Reasons for this observation could be found in the circadian muscle rhythms and muscle fatigue.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"52"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to start with hip arthroscopy in a safe and effective manner, using an evidence-based approach.","authors":"L Follet, V Khanduja, G Thevendran, O Ayeni, S Shanmugasundaram, M Abd El-Radi, H Said, A Abdelazeem, P Slullitel, O Marin-Peña, E Audenaert","doi":"10.1051/sicotj/2024031","DOIUrl":"https://doi.org/10.1051/sicotj/2024031","url":null,"abstract":"<p><p>Hip arthroscopy is a rapidly evolving field in orthopedics, offering diagnostic and therapeutic benefits for a range of hip pathologies. This review outlines a comprehensive guide to initiating hip arthroscopy safely and effectively using evidence-based practices. Optimal surgical outcomes depend on correct indications for surgery, in particular in the presence of borderline dysplasia and degenerative joint diseases. Proper patient counseling and setting realistic expectations are crucial for satisfactory outcomes and recovery. Physical examination, radiographs, MRI, and CT scans are essential for accurate diagnosis. In case of diagnostic uncertainty, the use of intra-articular injections can help confirm the diagnosis before surgery. Techniques for hip arthroscopy include central compartment first, peripheral compartment first, and outside-in approaches. Each technique has advantages, and the optimal approach depends on the specific case. Finally, Proper operating room setup, meticulous patient positioning, and precise portal placement are critical for a successful procedure. A thorough understanding of the safe zone anatomy for portal placement is essential to minimize the risk of neurovascular complications. In conclusion, this manuscript provides a detailed, evidence-based framework for starting hip arthroscopy, emphasizing the importance of technical proficiency, patient selection, and a multidisciplinary approach to ensure patient safety and procedure efficacy.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"35"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11415036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the interface between individual 3D acetabular implants and host bone influence the functional outcomes in patients with severe bone loss after revision surgery?","authors":"Valery Yu Murylev, Grigory A Kukovenko, Olga Efimenko, Aleksei V Muzychenkov, Pavel M Elizarov, Alexander I Rudnev, Semyon S Alekseev, Dmitrii O Golubkin","doi":"10.1051/sicotj/2024040","DOIUrl":"https://doi.org/10.1051/sicotj/2024040","url":null,"abstract":"<p><strong>Introduction: </strong>There is a wide range of commercially produced revision implants for adequate reconstruction of acetabular large bone defects today, however, it is not always possible to achieve long-term survival of these implants. There is an increasing number of scientific publications concerning the use of custom-designed 3D components, which make it possible not only to achieve stable fixation and connect the pelvic bones but also to restore hip joint biomechanics.</p><p><strong>Objectives: </strong>To evaluate the positioning of 3D acetabular implants after revision hip arthroplasty and its impact on clinical and functional outcomes.</p><p><strong>Methods: </strong>we analyzed results in 48 patients with bone defect types IIIA and IIIB Paprosky types, after revision hip arthroplasty. A prospective study was conducted from 2017 to 2023. Revision arthroplasty due to aseptic loosening of the components was performed in 30 cases and as a second stage of periprosthetic infection treatment in 18 cases.</p><p><strong>Results: </strong>We did not achieve a statistically significant difference when using additional flanges and clinical and functional results. In 2 cases we faced aseptic loosening in patients using flanges. In no case were we able to install an implant with 100% adherence to porous structure compared to preoperatively planned adherence. According to the WOMAC and VAS scales, increasing the contact area of the components showed a slight statistical difference in the improvement of clinical and functional results and the reduction of pain.</p><p><strong>Conclusions: </strong>When acetabular 3D components adhered to the bone by more than 68%, we did not register a single complication in the postoperative period, and acetabular 3D components adhered to the bone by less than 68%, a total of 8 (16.6%) complications were registered.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"42"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11504249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractures of the proximal femur and hip osteoarthrosis - coincidence or coherence?","authors":"David Latz, Erik Schiffner, Christos Koukos, Falk Hilsmann, Joachim Windolf, Johannes Schneppendahl","doi":"10.1051/sicotj/2024027","DOIUrl":"10.1051/sicotj/2024027","url":null,"abstract":"<p><strong>Purpose: </strong>The current study aimed to investigate the correlation between the grade of radiographic hip osteoarthritis (OA) and the fracture pattern observed in fragility fractures of the proximal femur. The information may help in cases of occult hip fractures.</p><p><strong>Methods: </strong>In this retrospective study all 448 patients treated with fragility fractures of the proximal femur in the years 2014-2018 were included. Patients were allocated into two groups: Group I) intracapsular (femoral neck) fractures and Group II) extracapsular (pertrochanteric and subtrochanteric) femoral fractures. The radiographic grade of OA was determined according to Kellgren and Lawrence's classification. One single observer examined all radiographs.</p><p><strong>Results: </strong>Patients' age ranged between 52 and 104 years with a mean of 80.0 years. There was a significant difference in mean age between the two groups (76.9 years intracapsular vs. 83.1 years extracapsular fractures). A total of 250 (55.8%) fractures were intracapsular (femoral neck) and 198 (44.2%) were located extracapsular (pertrochanteric, subtrochanteric). A significant correlation between the degree of OA to fracture pattern was observed: Higher degrees of OA were related to extracapsular fractures and lower degrees of OA to intracapsular fractures.</p><p><strong>Conclusion: </strong>The results of this study support the hypothesis that hip osteoarthritis affects the fracture pattern in proximal femur fractures. More severe hip OA is associated with extracapsular fractures that can be treated surgically with lower complication rates compared to intracapsular fractures.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"29"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11334697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between cephalic screw positioning of Standard Gamma 3 Nail for intertrochanteric fractures and cut-out incidence.","authors":"Alessandro Ortolani, Debora Lana, Antonio Martucci, Francesco Pesce, Stefano Stallone, Lorenzo Milani, Roberto Urso, Giuseppe Melucci, Domenico Tigani","doi":"10.1051/sicotj/2024006","DOIUrl":"10.1051/sicotj/2024006","url":null,"abstract":"<p><strong>Introduction: </strong>Lateral fractures of proximal femur are the most frequent fractures in elderly people. Internal fixation using medullary nails is the gold standard of treatment (Gamma 3 nail is the most implanted device) due to reduced incidence of complications than other devices. We report our experience in treating this kind of fractures with Gamma 3 nail, between January 2015 and December 2021.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of patients treated in our orthopaedic department; level of clinical care is III: 559 patients (431 females and 128 males, with an average age of 85.3 years) with lateral femoral neck fracture. All patients were surgically treated with Gamma 3 standard nail (SGN). We evaluated preliminary X-rays to classify fractures, according to AO-OTA classification and post-operative X-ray to verify cephalic screw position site, according to areas described by Cleveland in 1959: we measured tip-to-apex distance (TAD) and tip-to-apex calcar referred distance (CalTAD). Finally Chang reduction quality criteria (CRQC) for fracture reduction of trochanteric fractures were determined using preoperative or postoperative Antero-Posterior (AP) and lateral radiographs in a Picture Archiving and Communication System (PACS). Incidence of cut-out was evaluated in relation with these parameters. Patients were divided into 2 groups: first group had cephalic screw in optimal positions (5-8-9), the other group had cephalic screw in other positions.</p><p><strong>Results: </strong>In 328 patients (58.7%) screw was in positions 5-8-9, in 231 patients (41.2%) screw was in not-optimal position. Median TAD was 19.1 ± 7.0 mm (range = 0.0-50.5); in 463 patients (82.8%) TAD was ≤ 25 mm. Median CalTAD was 21.4 ± 4.7 mm (range = 5.7-39.2); in 105 patients (79.4%) CalTAD was ≤ 25 mm. Cut-out was observed in 8 cases (1.43%). Multivariate analysis showed a significant correlation (p < 0,05) between incidence of cut-out and fracture type 31A2 and with TAD values >25 mm. Cephalic screw position did not influence incidence of cut-out.</p><p><strong>Discussion: </strong>In order to obtain fracture healing with a low risk of failure, in particular cut-out, it is necessary to obtain good reduction of fracture and optimal lag screw position in order to achieve a TAD inferior to 25 mm.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"9"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difference in the anterior displacement of the tibial tuberosity relative to the proximal tibial fragment between opening wedge and closed wedge high tibial osteotomies.","authors":"Kentaro Kikuchi, Ken Kumagai, Shunsuke Yamada, Shuntaro Nejima, Hyonmin Choe, Hiroyuki Ike, Naomi Kobayashi, Yutaka Inaba","doi":"10.1051/sicotj/2024020","DOIUrl":"10.1051/sicotj/2024020","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the anterior-posterior (AP) displacement of the tibial tuberosity (TT) and to assess the difference between closed wedge and opening wedge high tibial osteotomies (OWHTO and CWHTO).</p><p><strong>Methods: </strong>One hundred consecutive knees with osteoarthritis that underwent OWHTO (50 knees) or CWHTO (50 knees) were investigated retrospectively. The femorotibial angle (FTA) was measured on AP radiographs of the knee. AP displacement of the TT, posterior tibial slope (PTS), the modified Blackburne-Peel index (mBPI), and the modified Caton-Deschamps index (mCDI) were measured on lateral radiographs of the knee.</p><p><strong>Results: </strong>Patients had a mean correction angle of 12.58 ± 2.84° and 18.98 ± 5.14° (P < 0.001), with a mean AP displacement of TT of 0.84 ± 2.66 mm and 7.78 ± 3.41 mm (P < 0.001) in OWHTO and CWHTO, respectively. The AP displacement of the TT per correction of 1° was significantly greater in CWHTO than in OWHTO (P < 0.001). A significant correlation was found between the correction angle and AP displacement of the TT in CWHTO (r = -0.523, P < 0.001), but not in OWHTO. The change of PTS per correction of 1° was significantly greater in OWHTO than in CWHTO (P < 0.001). The changes of mBPI and mCDI per correction of 1° were significantly greater in CWHTO than in OWHTO (P < 0.001 and P < 0.001, respectively).</p><p><strong>Conclusions: </strong>There was greater anterior displacement of the TT in CWHTO than in OWHTO, which was correlated with the correction angle. The results suggested that CWHTO would be better than OWHTO when a concomitant anteriorization of TT is required.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"21"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11141518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip displacement in children with cerebral palsy: surveillance to surgery - a current concepts review.","authors":"Jason J Howard, H Kerr Graham, Ashok Johari, Unni Narayanan, Lisa Bennett, Ana Presedo, Benjamin J Shore, Tatiana Guerschman, Alaric Aroojis","doi":"10.1051/sicotj/2024023","DOIUrl":"10.1051/sicotj/2024023","url":null,"abstract":"<p><p>This review brings together a multidisciplinary, multinational team of experts to discuss the current state of knowledge in the detection and treatment of hip displacement in cerebral palsy (CP), a global public health problem with a high disease burden. Though common themes are pervasive, different views are also represented, reflecting the confluence of traditional thinking regarding the aetiology and treatment of hip displacement in CP with emerging research that challenges these tried-and-true principles. The development of hip displacement is most closely related to gross motor function, with radiographic surveillance programs based on the Gross Motor Function Classification System (GMFCS), the goal being early detection and timely treatment. These treatments may include non-operative methods such as abduction bracing and Botulinum Neurotoxin A (BoNT-A), but outcomes research in this area has been variable in quality. This has contributed to conflicting opinions and limited consensus. Soft tissue lengthening of the hip adductors and flexors has traditionally been employed for younger patients, but population-based studies have shown decreased survivorship for this treatment when performed in isolation. Concerns with the identification of hip displacement in very young children are raised, noting that early reconstructive surgery has a high recurrence rate. This has prompted consideration of viable minimally invasive alternatives that may have better success rates in very young children with CP, or may at least delay the need for osteotomies. Recent reports have implicated the role of abnormal proximal femoral growth and secondary acetabular dysplasia as a primary cause of hip displacement, related to ambulatory status and abductor function. As such, guided growth of the proximal femur has emerged as a possible treatment that addresses this purported aetiology, with promising early results.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"10 ","pages":"30"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}