Long-term Effects of Femoral Derotation Osteotomies: An Evaluation Using Three-Dimensional Gait Analysis

Õunpuu, Sylvia; DeLuca, Peter A.; Davis, Roy B.; Romness, Mark

doi:10.1097/01241398-200203000-00001

Cited by 114 publications

(141 citation statements)

References 14 publications

Supporting

Mentioning

123

Contrasting

Unclassified

Order By: Relevance

“…If all trials showed similar patterns based on visual evaluation of the plots, the initial trial was selected. If two of three trials were similar, the first trial (of the two) was selected [7].…”

Section: Methodsmentioning

confidence: 99%

Local and distant effects of isolated calf muscle lengthening in children with cerebral palsy and equinus gait

Lofterød

Terjesen

2008

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

Purpose The purpose was to assess the local and distant effects of isolated calf muscle lengthening in ambulant children with cerebral palsy. Methods The study included fifteen ambulant children with cerebral palsy (nine with diplegia and six with hemiplegia), average age 8.8 years, Gross Motor Function Classification System (GMFCS) level I and II. None of the children had previously undergone orthopaedic surgery, apart from one child who had tendo-achilles lengthening (TAL) nine years earlier. All the children underwent pre and post-operative clinical examination and three-dimensional gait analysis (gait analysis). Twenty calf muscle lengthenings were performed, ten TAL and ten gastrocnemius recessions (GR). Results Post-operative ankle kinematics showed significant improvements in all parameters. Ankle power during push-off increased, but only significantly after TAL. Only one limb (5%) was over-corrected. Four limbs (20%) were under-corrected and one of these limbs remained in mild equinus position in stance. There was one recurrent equinus (5%) during the follow-up period of three years (range: 13-55 months). Distant effects on joints and segments were more marked in diplegia than in hemiplegia. Ten of 17 kinematic parameters distant from the ankle joint improved significant post-operatively when the preoperative values were 1SD below or above the mean of the normal material. There was no significant deterioration in any of the measured parameters. Conclusion The improvement in ankle kinematics and kinetics supported the experience of other studies. The distant effects, which have previously not been evaluated in three planes, showed improvement in several kinematic parameters indicating that additional surgery in selected patients could be abandoned or delayed.

show abstract

Section: Methodsmentioning

confidence: 99%

Local and distant effects of isolated calf muscle lengthening in children with cerebral palsy and equinus gait

Lofterød

Terjesen

2008

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

show abstract

“…Clinical followup studies showed improvement in PKF values were maintained after RF transfer, but improvements in knee ROM tended to decrease over time [9,16]. Moreau and Tinsley [8] compared the outcomes of a group of patients who had RF transfer as part of multilevel surgical procedures to another group of patients who did not undergo any RF procedure.…”

Section: Introductionmentioning

confidence: 99%

Rectus Femoris Distal Tendon Resection Improves Knee Motion in Patients With Spastic Diplegia

Presedo

Mégrot²,

Ilharreborde

et al. 2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Children with spastic diplegia frequently show excessive knee extension (stiff-knee gait) throughout swing phase, which may interfere with foot clearance. Abnormal rectus femoris activity is commonly associated with a stiff-knee gait. Rectus femoris transfer has been recommended to enhance knee flexion during swing. However, recent studies suggest the transfer does not generate a knee flexor moment but diminishes knee extension moment in swing and MRI studies show the transferred tendons can be constrained by scarring to underlying muscles. Thus, it is possible knee flexion would be improved by distal rectus release rather than transfer since it would not be adherent to the underlying muscles. Questions/purposes We therefore determined whether rectus femoris distal tendon resection improves knee ROM and kinematic characteristics of stiff-knee gait in patients with spastic diplegia. Patients and MethodsWe studied 45 patients who underwent rectus femoris distal tendon resection as a part of multilevel surgery. Rectus femoris procedures were indicated based on kinematic characteristics of stiff-knee gait. All patients were walkers and had a mean age at surgery of 13 years (range, 6-22 years). We obtained gait analyses before surgery and at mean 2-year followup. We based postoperative assessment on clinical evaluation and gait analysis data. Results At followup, rectus femoris distal tendon resection was associated with improved knee ROM and timing of peak knee flexion in swing, and the absolute values of peak knee flexion became normal for those patients who showed abnormal preoperative values.

show abstract

“…54 Correction of in-toed gait and medial femoral torsion by external rotation osteotomy of the femur is very effective and the results are lasting. 64 Proximal femoral osteotomy is the procedure of choice for in-toed gait in the presence of hip dysplasia or subluxation. If the hips are stable, distal femoral osteotomy is an equally effective procedure, which offers some advantages over proximal femoral osteotomy.…”

Section: Figmentioning

confidence: 99%

Musculoskeletal Aspects of Cerebral Palsy

Graham

Selber

2003

The Journal of Bone and Joint Surgery. British volume

357

331

View full text Add to dashboard Cite

Long-term Effects of Femoral Derotation Osteotomies: An Evaluation Using Three-Dimensional Gait Analysis

Cited by 114 publications

References 14 publications

Local and distant effects of isolated calf muscle lengthening in children with cerebral palsy and equinus gait

Local and distant effects of isolated calf muscle lengthening in children with cerebral palsy and equinus gait

Rectus Femoris Distal Tendon Resection Improves Knee Motion in Patients With Spastic Diplegia

Musculoskeletal Aspects of Cerebral Palsy

Contact Info

Product

Resources

About