Article

Stiff knee gait, which may be seen in patients with upper motor
neuron injury, describes a gait pattern with a relative loss of sagittal knee
motion. It interferes with foot clearance during swing, often leading to
inefficient compensatory mechanisms and ambulatory dysfunction. Distal rectus
femoris muscle transfers and fractional lengthening of the vastus muscles have
been performed in adult patients. OBJECTIVE: The purpose of this study was to
describe a unique surgical technique and report on initial outcomes. DESIGN: A
retrospective case-series study design was used. METHODS: The patients were
adults with stiff knee gait due to stroke or traumatic brain injury who underwent
distal rectus femoris muscle transfer with fractional lengthening of the vastus
muscles. The patients (19 men and 18 women) had an average age of 51 years at the
time of surgery. Lower-extremity examinations, clinical gait analyses, and
satisfaction levels were recorded preoperatively and postoperatively. RESULTS: At
a mean follow-up time of 10 months, 36 (97%) of the 37 patients were satisfied
with their clinical and functional results, and the average Viosca score improved
from 3.1 to 3.5. LIMITATIONS: Limitations of the study include use of a
retrospective design, lack of a control group, and limited quantitative measures
of gait. CONCLUSION: Distal rectus femoris muscle transfer and fractional
lengthening of the vastus muscles were found to be a possible treatment for
adults with stiff-knee gait caused by stroke or traumatic brain injury.

Langue : ANGLAIS