The effectiveness of European Hip Surveillance Programmes in the identification and management of hip displacement and hip dislocation in children with cerebral palsy: a systematic review

PURPOSE: To evaluate the effectiveness of European Hip Surveillance Programmes (HSPs) in the identification and surgical management of hip displacement/dislocation in children with Cerebral Palsy (CP), by systematically synthesising peer-reviewed evidence.

METHODS: Five databases (MEDLINE, CINAHL, Cochrane Library, Science Direct and PEDro) were systematically searched in July 2023, alongside manual searching of reference lists and key journals to identify relevant studies conducted in Europe and written in English. Data were extracted and quality appraised using Joanna Briggs Institute Checklist for Analytical Cross-Sectional Studies (JBI-CACCS) appraisal tool.

RESULTS: Six observational cross-sectional studies totalling 5069 participants met the inclusion criteria. Critical appraisal revealed good overall methodological quality. Results indicated HSPs were effective in identifying progressive hip displacement/dislocation. Five studies reported a significant decrease in prevalence of hip dislocation in children undergoing surveillance compared to controls. The need for salvage surgeries was abolished within surveillance groups across all included studies.

CONCLUSION: This review provides evidence that European HSPs can identify children at risk of developing hip displacement/dislocation and significantly reduce prevalence of dislocation. Future research including patient-reported outcomes such as pain, quality of life and burden of care for families may be useful to further evaluate effectiveness of HSPs.