IDENTIFICATION AND TREATMENT OF HIP INSTABILITY IN DOWN SYNDROME: A SCOPING REVIEW
Bibliographic record
Abstract
Hip instability is associated with Down syndrome (DS). The goal of this review was to examine the existing literature on hip instability in patients with DS as part of an effort to develop future hip surveillance guidelines similar to those established for people with cerebral palsy. A scoping review following PRISMA guidelines identified English-language, peer reviewed publications concerning hip instability or dysplasia in people with DS, including epidemiology, diagnosis and imaging, physical examination, other hip pathologies, surgical and nonsurgical interventions, from gestation to adulthood. PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane databases were queried with professional librarian assistance. Two independent reviewers screened abstracts and full texts. Discrepancies were resolved by group consensus. Studies were grouped by stage in life and content domains of epidemiology, morphology, diagnosis, and treatment. Validated critical appraisal tools were used. Eight-hundred and seventy-six articles were screened, and 54 full text articles with case series, cross sectional, and case control designs met criteria. Twenty-six articles describe pelvic morphology in people with DS including increased iliac indices, acetabular retroversion, and global acetabular insufficiency compared to peers. Joint laxity and altered hip kinetics during gait are noted in school age children and adults with DS. Slipped capital femoral epiphysis (SCFE) and Perthes disease in patients with DS appeared to have worse outcomes than peers without DS. Large studies identified 28% of adults with DS with hip abnormalities. Sixteen articles reported on surgical interventions and outcomes among school age, adolescents, and adults with DS treated for hip instability and dysplasia with good outcomes. Periacetabular Ganz osteotomy and total hip arthroplasty procedures appeared to provide good outcomes for skeletally mature people with DS, but with higher complication rates than in people without DS. A scoping review of the literature demonstrates that the risk of hip pathology among people with DS is increased, independent of life stage. In light of this, early and regular radiographic and physical examination may be warranted. There are a limited number of studies regarding nonoperative management of hip instability associated with DS. This review revealed mixed surgical outcomes and a variety of procedures for treatment of hip instability in DS. Consensus building among experts will be necessary to develop guidelines for hip surveillance and management for people with DS.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.021 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.009 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".