Article

Current surgery outcome evaluations in patients with Legg-Calve-Perthes disease
(LCPD) are usually based on static radiological changes.
The aim of the present
study was to assess the development of characteristic gait parameters and passive
hip range of motion (ROM) measurements during the postoperative period up to
healed stage of the femoral head represented by Stulberg classification. Twelve
children (10 male, 2 female) with unilateral diagnosis of LCPD and 19 healthy
control subjects at the same age participated in this prospective longitudinal
study. Instrumented gait analysis was performed preoperatively, 13.4 (+/-1.7),
and 28.0 (+/-4.4) months postoperatively. At final follow-up, the mean leg length
of the involved side was reduced by 1.10 (+/-0.53)cm compared to the non-involved
side. In addition, a significant reduction in maximum knee flexion (-26%,
p=0.037) and knee flexion/extension ROM (-26%, p=0.017) in stance was still
present in the patient group compared to controls indicating a "stiff knee gait
pattern". In contrast, the sagittal plane hip parameters, the ipsilateral trunk
lean toward the involved stance limb, and the knee and hip joint loading during
gait normalized during the postoperative period. The results of the present study
should motivate further exploration if patients with LCPD stiffen their knees to
compensate for leg length discrepancy. Besides the standard radiological
evaluation of the surgery outcome, instrumented gait analysis is a valuable
method of recording functional deficits and early recognition of the need for
physiotherapeutic treatment or insole supply in patients with LCPD.
CI - Copyright (c) 2016. Published by Elsevier B.V.

Langue : ANGLAIS