Article

Flexed knee gait can be treated with distal femoral extension osteotomy
(DFEO) and additional patellar tendon advancement (PTA) in children with cerebral
palsy (CP). This study assesses changes in hamstring muscle tendon length (MTL)
and velocity after DFEO (+PTA). METHOD: Nineteen children (mean age 13y [standard
deviation 3y] at surgery) with CP and flexed knee gait who were treated with DFEO
(15 limbs) or DFEO+PTA (10 limbs) were retrospectively included in this study.
Gait analyses were performed preoperatively (E0), 1 year postoperatively (E1),
and for 10 limbs additionally 2 to 5 years postoperatively (E2). Hamstring MTL
and velocities were assessed at all examination dates using OpenSim. RESULTS:
Hamstring MTL and velocity did not change significantly over time. From E0 to E1,
knee flexion in stance improved for both DFEO and DFEO+PTA (p<0.05), knee flexion
in swing only improved after DFEO+PTA (p<0.05). The improved knee flexion in
stance and swing was maintained at E2. INTERPRETATION: DFEO led to a significant
improvement in knee kinematics at E1 which was maintained at E2. DFEO seems to
prevent recurrent hamstring tightness but does not lead to lengthened or fastened
hamstrings. WHAT THIS PAPER ADDS: Distal femoral extension osteotomy (DFEO) does
not change hamstring muscle tendon length. DFEO does not change hamstring
lengthening velocity. DFEO leads to a significant improvement in knee kinematics.
Changes in knee kinematics after DFEO can be maintained at mid-term. DFEO seems
to prevent recurrent hamstring tightness.
CI - (c) 2018 Mac Keith Press.

Langue : ANGLAIS