Satisfactory long-term functional and radiological outcomes following hip reconstructive surgery in children with cerebral palsy.
Kathleen Montpetit, Souad Rhalmi, Mathieu Lalumiere and 4 others
PMID 40111898WHAT IT FOUND
At mean 8.4 years after hip surgery, parents reported better health, leg function, activity and pain, and hip radiographs improved.
Without a control group or pre-surgery pain scores, the surgery's effect is not proven.
Key findings
01At final follow-up, parents reported better overall health (76%), leg function (58%), activity level (63%) and pain (68%), and 76% were satisfied with overall changes.
02Among 45 hips with pre- and post-operative radiographs, hip displacement improved significantly by 36.7%, and the number of located hips rose from 11 to 39.
03Caregivers still reported difficulty with standing-frame positioning (45%), wheelchair transfers (32%), diaper changes (38%) and bathing (34%).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study had no control group, so it cannot show that the surgery caused the reported improvements. Pain and caregiving burden were not measured before surgery, so positive reports at follow-up cannot be solely attributed to the operation. It was a single-site study with a small sample, which reduced statistical power. Records were reviewed for 92 children, but 44 were included after losses to follow-up, refusals and death. Because several different surgical procedures were included, the contribution of any single technique cannot be separated. Parent recall bias and reliance on medical records may have affected the reported outcomes. Exploratory correlations between radiological findings and function used small subgroup numbers.
Declared interests
The authors reported no financial support for the research, authorship or publication, and no potential conflicts of interest.
The easy way to misread this
Do not conclude that hip surgery caused the improvements or that it removed caregiving burden. The study had no control group and no pre-operative pain or function scores, and parents still reported difficulty with transfers, diapering, bathing and standing-frame positioning.