The action of the rectus femoris muscle following distal tendon transfer: does it generate knee flexion moment?

Riewald, Scott; Delp, Scott L.

doi:10.1111/j.1469-8749.1997.tb07391.x

Cited by 88 publications

(60 citation statements)

References 10 publications

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“…Perry [13] recommended transferring the RF to the hamstrings to generate a knee flexor moment. Several studies from the last decade focused on understanding the action of the RF after distal tendon transfer [1,2,5,14]. These studies showed the RF did not generate a flexor moment after being transferred to the posterior side of the knee.…”

Section: Discussionmentioning

confidence: 99%

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

Presedo

Mégrot²,

Ilharreborde

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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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.

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Section: Discussionmentioning

confidence: 99%

“…Riewald and Delp [14] investigated whether the RF converts to a knee flexor after being transferred to the semitendinosus muscle or to the iliotibial band. Rectus femoris EMG activity showed the muscle generated an extensor moment in all of their subjects.…”

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

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“…However, some authors have reported discrepant outcomes after DRFT [6,18,30,35], and a poor or no response rate of approximately 20% was found in a recent long-term investigation [6]. These inconsistent outcomes may be explained by a persistent extensor moment of the rectus femoris after transfer [2,3,28]. In such cases an additional proximal rectus femoris release may have an additional beneficial effect on knee motion.…”

Section: Discussionmentioning

confidence: 99%

“…Our results that there were no differences between those patients who received additional proximal release and those who did not may indicate that the proximal rectus femoris release does not relevantly influence this mechanism. (2) In cases of a persistent internal knee extensor moment of the rectus femoris on the knee after DRFT [2,3,28], additional surgery in the proximal part does not affect knee function. Therefore, although clearly combined in biomechanics, clinically hip flexion and knee extension appear to be independent functions of the rectus femoris.…”

Section: Discussionmentioning

confidence: 99%

“…The beneficial effects after distal rectus femoris transfer (DRFT) for knee kinematics are well documented; however, inconsistent results have been reported [8,11,18,20,21,27,30,33], and in some patients no effect was observed after DRFT [6]. Some authors suggested that even after transfer, a knee extensor moment remains in the rectus femoris [2,3,28].…”

Section: Introductionmentioning

confidence: 99%

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Does Proximal Rectus Femoris Release Influence Kinematics In Patients With Cerebral Palsy and Stiff Knee Gait?

Végvári

Wolf

Heitzmann

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Stiff gait resulting from rectus femoris dysfunction in cerebral palsy commonly is treated by distal rectus femoris transfer (DRFT), but varying outcomes have been reported. Proximal rectus femoris release was found to be less effective compared with DRFT. No study to our knowledge has investigated the effects of the combination of both procedures on gait. Questions/purposes We sought to determine whether an additional proximal rectus release affects knee and pelvic kinematics when done in combination with DRFT; specifically, we sought to compare outcomes using the (1) range of knee flexion in swing phase, (2) knee flexion velocity and (3) peak knee flexion in swing phase, and (4) spatiotemporal parameters between patients treated with DRFT, with or without proximal rectus release. Furthermore the effects on (5) anterior pelvic tilt in both groups were compared. Methods Twenty patients with spastic bilateral cerebral palsy treated with DRFT and proximal rectus femoris release were matched with 20 patients in whom only DRFT was performed. Standardized three-dimensional gait analysis was done before surgery, at 1 year after surgery, and at a mean of 9 years after surgery. Basic statistics were done to compare the outcome of both groups. Results The peak knee flexion in swing was slightly increased in both groups 1 year after surgery, but was not different between groups. Although there was a slight but not significant decrease found the group with DRFT only, there was no significant difference at long-term followup between the groups. Timing of peak knee flexion, range of knee flexion, and knee flexion velocity improved significantly in both groups, and in both groups a slight deterioration was seen with time; there were no differences in these parameters between the groups at any point, however. There were no group differences in spatiotemporal parameters at any time. There were no significant differences in the long-term development of anterior pelvic tilt between the groups. Conclusions The results of our study indicate that the short-and long-term influences of adding proximal rectus femoris release on the kinematic effects of DRFT and on pelvic tilt in children with cerebral palsy are negligible.

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Muscle, Biomechanics, and Implications for Neural Control

Ting

Chiel

2017

Neurobiology of Motor Control

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The action of the rectus femoris muscle following distal tendon transfer: does it generate knee flexion moment?

Cited by 88 publications

References 10 publications

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

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

Does Proximal Rectus Femoris Release Influence Kinematics In Patients With Cerebral Palsy and Stiff Knee Gait?

Muscle, Biomechanics, and Implications for Neural Control

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