Iliopsoas Transfer in Cerebral Palsy: The Long-Term Outcome

Erken, Einhard H. W.; Bischof, F

doi:10.1097/01241398-199405000-00004

Cited by 13 publications

(4 citation statements)

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“…Scaffold-induced neotendons and autografts do not work either, as there is nothing living beyond the gap to which such tissues can heal. Tendon-transfer procedures involve reattaching and retraining of muscles can allow dramatic rehabilitation [2], but the available length of native tendons limits availability to a few patients [15], limits potential applications, and adversely affects long-term outcome [16, 17]. Revision arthroplasty will become more common [3], despite increases in the durability of artificial joints.…”

Section: Introductionmentioning

confidence: 99%

“…15 This can allow dramatic rehabilitation, 2 but the available length of native tendons limits availability to a few patients, 15 adversely affects long-term outcome of some applications, and precludes many potential others. 16,17 An artificial tendon could be made any needed length. Revision arthroplasty will become more common, 3 despite increases in the durability of artificial joints.…”

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confidence: 99%

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An artificial tendon to connect the quadriceps muscle to the Tibia

Melvin¹,

Litsky²,

Mayerson³

et al. 2011

Journal Orthopaedic Research

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No permanent, reliable artificial tendon exists clinically. Our group developed the OrthoCoupler™ device as a versatile connector, fixed at one end to a muscle, and adaptable at the other end to inert implants such as prosthetic bones or to bone anchors. The objective of this study was to evaluate four configurations of the device to replace the extensor mechanism of the knee in goats. Within muscle, the four groups had: (A) needle-drawn uncoated bundles, (B) needle-drawn coated bundles, (C) barbed uncoated bundles, and (D) barbed coated bundles. The quadriceps tendon, patella, and patellar tendon were removed from the right hind limb in 24 goats. The four groups (n=6 for each) were randomly assigned to connect the quadriceps muscle to the tibia (with a bone plate). Specimens were collected from each operated leg and contralateral unoperated controls both for mechanical testing and histology at 90 days post-surgery. In strength testing, maximum forces in the operated leg (vs. unoperated control) were 1288±123 N (vs. 1387±118 N) for group A, 1323±144 N (vs. 1396±779 N) for group B, 930±125 N (vs. 1337±126 N) for group C, and 968±109 N (vs. 1528±146 N) for group D (mean ± SEM). The strengths of the OrthoCoupler™ legs in the needled device groups were equivalent to unoperated controls (p=0.6), while both barbed device groups had maximum forces significantly lower than their controls (p=0.001). We believe this technology will yield improved procedures for clinical challenges in orthopaedic oncology, revision arthroplasty, tendon transfer, and tendon injury reconstruction.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

An artificial tendon to connect the quadriceps muscle to the Tibia

Melvin¹,

Litsky²,

Mayerson³

et al. 2011

Journal Orthopaedic Research

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“…Tendon transfer procedures involve reattaching and retraining of muscles, such as the “borrowing” of extensor muscles from a flexor group to restore motor function lost to cerebral palsy2 or peripartum brachial plexus injury 27. This can allow dramatic rehabilitation,2 but the available length of native tendons limits availability to a few patients27 and adversely affects long‐term outcome of some applications 28, 29. An artificial tendon could be made any needed length.…”

Section: Discussionmentioning

confidence: 99%

Extended healing validation of an artificial tendon to connect the quadriceps muscle to the Tibia: 180‐day study

Melvin¹,

Litsky²,

Mayerson³

et al. 2011

Journal Orthopaedic Research

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Whenever a tendon or its bone insertion is disrupted or removed, existing surgical techniques provide a temporary connection or scaffolding to promote healing, but the interface of living to nonliving materials soon breaks down under the stress of these applications, if it must bear the load more than acutely. Patients are thus disabled whose prostheses, defect size, or mere anatomy limit the availability or outcomes of such treatments. Our group developed the OrthoCoupler™ device to join skeletal muscle to prosthetic or natural structures without this interface breakdown. In this study, the goat knee extensor mechanism (quadriceps tendon, patella, and patellar tendon) was removed from the right hind limb in 16 goats. The device connected the quadriceps muscle to a stainless steel bone plate on the tibia. Mechanical testing and histology specimens were collected from each operated leg and contra lateral unoperated control legs at 180 days. Maximum forces in the operated leg (vs. unoperated) were 1400± 93N (vs. 1179± 61 N), linear stiffnesses were 33± 3 N/mm (vs. 37 ± 4N/mm), and elongations at failure were 92.1 ± 5.3 mm (vs. 68.4 ± 3.8 mm; mean ± SEM). Higher maximum forces (p = 0.02) and elongations at failure (p = 0.008) of legs with the device versus unoperated controls were significant; linear stiffnesses were not (p = 0.3). We believe this technology will yield improved procedures for clinical challenges in orthopaedic oncology, revision arthroplasty, tendon transfer, and tendon injury reconstruction.

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“…Studies have reported on long-term outcome of various orthopaedic procedures and long bone fractures in residents of longterm care facilities. [1][2][3] Recently the group focused on several outcomes in children and adolescents with a diagnosis of spastic diplegia (SD). The paediatricians asked whether in an era of rapid technological and therapeutic advances in neonatology, severe and complicated SD was being seen with the same frequency as in the past.…”

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confidence: 99%