Recurrence of Equinus Foot in Cerebral Palsy following Its Correction-A Meta-Analysis
Background: Recurrence in cerebral palsy (CP) patients who have undergone operative or non-operative correction varies greatly from one study to another. Therefore, we conducted this meta-analysis to determine the pooled rate of equinus recurrence following its correction either surgically or non-su...
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Published in | Children (Basel) Vol. 9; no. 3; p. 339 |
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Format | Journal Article |
Language | English |
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02.03.2022
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Abstract | Background: Recurrence in cerebral palsy (CP) patients who have undergone operative or non-operative correction varies greatly from one study to another. Therefore, we conducted this meta-analysis to determine the pooled rate of equinus recurrence following its correction either surgically or non-surgically. Methods: Nine electronic databases were searched from inception to 6 May 2021, and the search was updated on 13 August 2021. We included all studies that reported the recurrence rate of equinus following its correction among CP patients. The primary outcome was recurrence, where data were reported as a pooled event (PE) rate and its corresponding 95% confidence interval (CI). We used the Cochrane’s risk of bias (RoB-II) tool and ROBINS-I tool to assess the quality of included randomized and non-randomized trials, respectively. We conducted subgroup analyses to identify the sources of heterogeneity. Results: The overall rate of recurrence was 0.15 (95% CI: 0.05−0.18; I2 = 88%; p < 0.01). Subgroup analyses indicated that the laterality of CP, study design, and intervention type were significant contributors to heterogeneity. The recurrence rate of equinus differed among interventions; it was highest in the multilevel surgery group (PE = 0.27; 95% CI: 0.19−0.38) and lowest in the Ilizarov procedure group (PE = 0.10; 95% CI: 0.04−0.24). Twelve studies had a low risk of bias, eight had a moderate risk, and nine had a serious risk of bias. Conclusion: The recurrence of equinus following its correction, either surgically or non-surgically, in CP patients is notably high. However, due to the poor quality of available evidence, our findings should be interpreted with caution. Future studies are still warranted to determine the actual risk of equinus recurrence in CP. |
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AbstractList | Background: Recurrence in cerebral palsy (CP) patients who have undergone operative or non-operative correction varies greatly from one study to another. Therefore, we conducted this meta-analysis to determine the pooled rate of equinus recurrence following its correction either surgically or non-surgically. Methods: Nine electronic databases were searched from inception to 6 May 2021, and the search was updated on 13 August 2021. We included all studies that reported the recurrence rate of equinus following its correction among CP patients. The primary outcome was recurrence, where data were reported as a pooled event (PE) rate and its corresponding 95% confidence interval (CI). We used the Cochrane’s risk of bias (RoB-II) tool and ROBINS-I tool to assess the quality of included randomized and non-randomized trials, respectively. We conducted subgroup analyses to identify the sources of heterogeneity. Results: The overall rate of recurrence was 0.15 (95% CI: 0.05–0.18; I2 = 88%; p < 0.01). Subgroup analyses indicated that the laterality of CP, study design, and intervention type were significant contributors to heterogeneity. The recurrence rate of equinus differed among interventions; it was highest in the multilevel surgery group (PE = 0.27; 95% CI: 0.19–0.38) and lowest in the Ilizarov procedure group (PE = 0.10; 95% CI: 0.04–0.24). Twelve studies had a low risk of bias, eight had a moderate risk, and nine had a serious risk of bias. Conclusion: The recurrence of equinus following its correction, either surgically or non-surgically, in CP patients is notably high. However, due to the poor quality of available evidence, our findings should be interpreted with caution. Future studies are still warranted to determine the actual risk of equinus recurrence in CP. Background: Recurrence in cerebral palsy (CP) patients who have undergone operative or non-operative correction varies greatly from one study to another. Therefore, we conducted this meta-analysis to determine the pooled rate of equinus recurrence following its correction either surgically or non-surgically. Methods: Nine electronic databases were searched from inception to 6 May 2021, and the search was updated on 13 August 2021. We included all studies that reported the recurrence rate of equinus following its correction among CP patients. The primary outcome was recurrence, where data were reported as a pooled event (PE) rate and its corresponding 95% confidence interval (CI). We used the Cochrane’s risk of bias (RoB-II) tool and ROBINS-I tool to assess the quality of included randomized and non-randomized trials, respectively. We conducted subgroup analyses to identify the sources of heterogeneity. Results: The overall rate of recurrence was 0.15 (95% CI: 0.05−0.18; I2 = 88%; p < 0.01). Subgroup analyses indicated that the laterality of CP, study design, and intervention type were significant contributors to heterogeneity. The recurrence rate of equinus differed among interventions; it was highest in the multilevel surgery group (PE = 0.27; 95% CI: 0.19−0.38) and lowest in the Ilizarov procedure group (PE = 0.10; 95% CI: 0.04−0.24). Twelve studies had a low risk of bias, eight had a moderate risk, and nine had a serious risk of bias. Conclusion: The recurrence of equinus following its correction, either surgically or non-surgically, in CP patients is notably high. However, due to the poor quality of available evidence, our findings should be interpreted with caution. Future studies are still warranted to determine the actual risk of equinus recurrence in CP. Background: Recurrence in cerebral palsy (CP) patients who have undergone operative or non-operative correction varies greatly from one study to another. Therefore, we conducted this meta-analysis to determine the pooled rate of equinus recurrence following its correction either surgically or non-surgically. Methods: Nine electronic databases were searched from inception to 6 May 2021, and the search was updated on 13 August 2021. We included all studies that reported the recurrence rate of equinus following its correction among CP patients. The primary outcome was recurrence, where data were reported as a pooled event (PE) rate and its corresponding 95% confidence interval (CI). We used the Cochrane’s risk of bias (RoB-II) tool and ROBINS-I tool to assess the quality of included randomized and non-randomized trials, respectively. We conducted subgroup analyses to identify the sources of heterogeneity. Results: The overall rate of recurrence was 0.15 (95% CI: 0.05–0.18; I 2 = 88%; p < 0.01). Subgroup analyses indicated that the laterality of CP, study design, and intervention type were significant contributors to heterogeneity. The recurrence rate of equinus differed among interventions; it was highest in the multilevel surgery group (PE = 0.27; 95% CI: 0.19–0.38) and lowest in the Ilizarov procedure group (PE = 0.10; 95% CI: 0.04–0.24). Twelve studies had a low risk of bias, eight had a moderate risk, and nine had a serious risk of bias. Conclusion: The recurrence of equinus following its correction, either surgically or non-surgically, in CP patients is notably high. However, due to the poor quality of available evidence, our findings should be interpreted with caution. Future studies are still warranted to determine the actual risk of equinus recurrence in CP. |
Author | Horsch, Axel Seide, Svenja Elisabeth Ghandour, Maher Klotz, Matthias Claus Michael Platzer, Hadrian |
AuthorAffiliation | 2 Marienkrankenhaus Soest, Orthopedics and Trauma Surgery, 59494 Soest, Germany; mcmklotz@gmx.net 3 Institute of Medical Biometry, University of Heidelberg, 69117 Heidelberg, Germany; seide@imbi.uni-heidelberg.de 1 Department of Orthopedics and Trauma Surgery, Heidelberg University Hospital, 69120 Heidelberg, Germany; hadrian.platzer@med.uni-heidelberg.de (H.P.); mghandourmd@gmail.com (M.G.) |
AuthorAffiliation_xml | – name: 2 Marienkrankenhaus Soest, Orthopedics and Trauma Surgery, 59494 Soest, Germany; mcmklotz@gmx.net – name: 1 Department of Orthopedics and Trauma Surgery, Heidelberg University Hospital, 69120 Heidelberg, Germany; hadrian.platzer@med.uni-heidelberg.de (H.P.); mghandourmd@gmail.com (M.G.) – name: 3 Institute of Medical Biometry, University of Heidelberg, 69117 Heidelberg, Germany; seide@imbi.uni-heidelberg.de |
Author_xml | – sequence: 1 givenname: Axel orcidid: 0000-0002-6487-030X surname: Horsch fullname: Horsch, Axel organization: Department of Orthopedics and Trauma Surgery, Heidelberg University Hospital, 69120 Heidelberg, Germany – sequence: 2 givenname: Matthias Claus Michael surname: Klotz fullname: Klotz, Matthias Claus Michael organization: Marienkrankenhaus Soest, Orthopedics and Trauma Surgery, 59494 Soest, Germany – sequence: 3 givenname: Hadrian orcidid: 0000-0001-9805-3810 surname: Platzer fullname: Platzer, Hadrian organization: Department of Orthopedics and Trauma Surgery, Heidelberg University Hospital, 69120 Heidelberg, Germany – sequence: 4 givenname: Svenja Elisabeth surname: Seide fullname: Seide, Svenja Elisabeth organization: Institute of Medical Biometry, University of Heidelberg, 69117 Heidelberg, Germany – sequence: 5 givenname: Maher orcidid: 0000-0002-6374-0626 surname: Ghandour fullname: Ghandour, Maher organization: Department of Orthopedics and Trauma Surgery, Heidelberg University Hospital, 69120 Heidelberg, Germany |
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Snippet | Background: Recurrence in cerebral palsy (CP) patients who have undergone operative or non-operative correction varies greatly from one study to another.... |
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SubjectTerms | Ankle Bias Cerebral palsy equinus Meta-analysis Pediatrics recurrence Software Surgery Systematic Review |
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Title | Recurrence of Equinus Foot in Cerebral Palsy following Its Correction-A Meta-Analysis |
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