title: The effect of femoral derotation osteotomy on transverse plane hip and pelvic kinematics in children with cerebral palsy: a systematic review and meta-analysis.
abstract: The purpose of this study was to systematically review the current literature to determine the effect of a femoral derotation osteotomy (FDRO) on hip and pelvic rotation kinematics during gait compared to no intervention in children with spastic cerebral palsy (CP). We performed a systematic search for prospective and retrospective cohort studies of children with CP, who were treated with a FDRO, and were assessed with pre and post surgery three-dimensional gait analysis. Medline, CINAHL, EMBASE, the Cochrane Library and Web of Science were searched up to December 2013. Data sources were prospective and retrospective studies. Mean differences were calculated on pooled data for both pelvic and hip rotation kinematics. Thirteen of 196 articles met the inclusion criteria (5 prospective, 8 retrospective). All included studies were of sufficient quality for meta-analysis as assessed using a customised version of the STROBE checklist. Meta-analysis showed that FDRO significantly reduced pelvic retraction by 9.0 degrees and hip internal rotation by 17.6 degrees in participants with unilateral CP involvement and hip internal rotation by 14.3 degrees in participants with bilateral CP involvement. Pelvic symmetry in children with unilateral spastic CP is significantly improved by FDRO. Patients with bilateral involvement do not improve their transverse plane pelvic rotation profiles during gait as a result to FDRO, although this result should be interpreted with caution due to the heterogeneous nature of these participants and of the methods used in the studies assessed.
authors.affiliation: Queensland Children's Gait Laboratory, Royal Children's Hospital, Brisbane, Australia; Centre for Musculoskeletal Research, Griffith Health Institute and School of Allied Health Sciences, Griffith University, Gold Coast, Australia. Electronic address: Christopher_carty@health.qld.gov.au.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Carty
authors.affiliation: Queensland Children's Gait Laboratory, Royal Children's Hospital, Brisbane, Australia.
authors.forename: Henry P J
authors.initials: HP
authors.lastname: Walsh
authors.affiliation: Queensland Children's Gait Laboratory, Royal Children's Hospital, Brisbane, Australia; Queensland Cerebral Palsy and Rehabilitation Research Centre, the University of Queensland, Brisbane, Australia.
authors.forename: Jarred G
authors.initials: JG
authors.lastname: Gillett
authors.affiliation: Queensland Children's Gait Laboratory, Royal Children's Hospital, Brisbane, Australia.
authors.forename: Teresa
authors.initials: T
authors.lastname: Phillips
authors.affiliation: Queensland Children's Gait Laboratory, Royal Children's Hospital, Brisbane, Australia.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Edwards
authors.affiliation: Queensland Children's Gait Laboratory, Royal Children's Hospital, Brisbane, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: deLacy
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, the University of Queensland, Brisbane, Australia.
authors.forename: Roslyn N
authors.initials: RN
authors.lastname: Boyd
mesh_terms: D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D005269:Femur / Q000503:physiopathology / Q000601:surgery*; D005684:Gait / Q000502:physiology*; D006429:Hemiplegia / Q000503:physiopathology / Q000601:surgery*; D006615:Hip / Q000503:physiopathology / Q000601:surgery*; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D010027:Osteotomy / Q000379:methods*; D012399:Rotation
keywords: Cerebral palsy; Gait; Osteotomy; Systematic review