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1.
Thawrani D Haumont T Church C Holmes L Dabney KW Miller F 《Clinical orthopaedics and related research》2012,470(5):1303-1311
Background
Stiff knee gait is common among children with ambulatory cerebral palsy (CP). When surgery is indicated, rectus femoris transfer as a primary treatment enhances knee range of motion, reduces time to peak knee flexion, increases peak knee flexion, and reduces toe drag. 相似文献2.
Goldberg EJ Fowler EG Oppenheim WL 《Clinical orthopaedics and related research》2012,470(5):1320-1326
Background
Preliminary evidence suggests selective voluntary motor control (SVMC), defined as performance of isolated voluntary joint movement on request, may be an important factor affecting functional movement tasks. Individuals with poor SVMC are unable to dissociate hip and knee synergistic movement during the swing phase of gait and have difficulty extending their knee while the hip is flexing during terminal swing regardless of hamstring length. This pattern may limit their ability to take advantage of hamstring-lengthening surgery (HLS) and may explain a lack of improved stride length postoperatively. 相似文献3.
Saw A Smith PA Sirirungruangsarn Y Chen S Hassani S Harris G Kuo KN 《Journal of pediatric orthopedics》2003,23(5):672-678
The purpose of this study was to evaluate the long-term results of rectus femoris transfer in cerebral palsy children with stiff-knee gait. Thirty-eight affected limbs in 24 children were evaluated preoperatively and 1 year postoperatively by gait analysis, with 26 limbs in 18 patients having final study, averaging 4.6 years postoperatively. Functional ambulatory status was evaluated based on Hoffer's criteria on ambulation. There were statistically significant improvements of 9.8 degrees in maximum swing-phase knee flexion and 7.0 degrees in total range of knee motion at 1 year, with a small loss of knee extension in stance. At final gait analysis, the improvement in the swing-phase knee flexion was maintained, but improvement in total range of knee motion was decreased. There were no significant changes in temporal parameters. Improvement in swing-phase knee flexion and foot clearance after rectus femoris transfer was associated with loss of knee extension at long-term follow-up. Hamstring lengthening in patients who develop excessive stance-phase knee flexion may be necessary. 相似文献
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Objectives
Change of function of the rectus femoris through medial transfer of its distal tendon. This procedure transforms a hip flexor and knee extensor into a hip and knee flexor. Thus the muscle acts as a hip flexor during the terminal stance phase and swing phase and as a knee flexor during the swing phase. This permits the foot to clear the ground and to improve the spastic gait. 相似文献6.
Casartelli NC Leunig M Item-Glatthorn JF Lepers R Maffiuletti NA 《International orthopaedics》2012,36(5):967-973
Purpose
Patients with symptomatic femoroacetabular impingement (FAI) have considerable hip muscle weakness, in particular, hip flexion and hip adduction. In addition, they experience disabilities while performing prolonged dynamic tasks. It was therefore postulated that, besides hip flexor muscle weakness, patients with symptomatic FAI would show greater hip flexor fatigue compared with healthy controls. 相似文献7.
Yoram Hemo Michael D. Aiona Rosemary A. Pierce Robin Dorociak Michael D. Sussman 《Journal of children's orthopaedics》2007,1(1):37-41
Purpose To assess the outcome of children with cerebral palsy following reposition of the distal rectus femoris tendon for treatment
of stiff knee gait.
Methods Children with cerebral palsy with stiff knee gait who underwent rectus femoris transfer were studied retrospectively. Inclusion
criteria were cerebral palsy of diplegic or quadriplegic type, preoperative and 1 year postoperative three-dimensional motion
analysis, and no other surgery except rectus femoris transfer at the time of study. The patients were separated into two groups:
in group I, the rectus femoris was transferred to the distal medial hamstring tendons, either the gracilis or the semitendinosus;
in group II, the distal tendon of the rectus femoris was transposed laterally and attached to the iliotibial band/intermuscular
septum.
Results Peak knee flexion during swing phase, total dynamic knee range of motion, knee range of motion during swing phase, and time
to peak knee flexion during swing phase were all improved in both groups. Hip and pelvic kinematics were not influenced by
the surgery. Velocity, stride length, and cadence were all improved following the surgery. There was no difference between
the transfer group and the transposition group.
Conclusion These findings suggest that distal transfer of the rectus femoris is effective in improving swing phase knee function by diminishing
the mechanical effect of the dysphasic swing phase activity of the rectus femoris, not by converting the rectus femoris to
an active knee flexor.
No financial support was received for this study. 相似文献
8.
Rutz E Passmore E Baker R Graham HK 《Clinical orthopaedics and related research》2012,470(5):1294-1302
Background
Multilevel orthopaedic surgery may improve gait in Type IV hemiplegia, but it is not known if proximal femoral osteotomy combined with adductor release as part of multilevel surgery in patients with hip dysplasia improves hip development. 相似文献9.
Treatment of stiff-knee gait in cerebral palsy: a comparison by gait analysis of distal rectus femoris transfer versus proximal rectus release 总被引:6,自引:0,他引:6
Two groups of patients with cerebral palsy (CP) were studied pre- and postoperatively by gait analysis after proximal release or distal transfer of the rectus femoris for treatment of knee stiffness in swing phase. In the first group studied, 12 patients underwent proximal rectus femoris muscle release. In the second group, 10 patients underwent distal rectus femoris transfer. After surgery, peak knee flexion was increased 9.1 degrees in swing phase by proximal rectus release and 16.2 degrees by distal rectus transfer. Hip motion throughout the gait cycle was not significantly affected by either operation, and no tendency for a crouch gait was observed after either procedure. 相似文献
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Background
External tibial torsion causes an abnormal axis of joint motion relative to the line of progression with resultant abnormal coronal plane knee moments and affects lever arm function of the foot in power generation at the ankle. However, it is unclear whether surgical correction of the tibial torsion corrects the moments and power. 相似文献12.
Bruni D Iacono F Raspugli G Zaffagnini S Marcacci M 《Clinical orthopaedics and related research》2012,470(5):1442-1451
Background
The literature suggests survivorship of unicompartmental knee arthroplasties (UKAs) for spontaneous osteonecrosis of the knee ranges from 93% to 97% at 10 to 12 years. However, these data arise from small series (23 to 33 patients), jeopardizing meaningful conclusions. 相似文献13.
Asakawa DS Blemker SS Rab GT Bagley A Delp SL 《The Journal of bone and joint surgery. American volume》2004,(2):348-354
BACKGROUND: Rectus femoris tendon transfer is performed in patients with cerebral palsy to improve knee flexion during walking. This procedure involves detachment of the muscle from its insertion into the quadriceps tendon and reattachment to one of the knee flexor muscles. The purpose of the present study was to evaluate the muscle-tendon geometry and to assess the formation of scar tissue between the rectus femoris and adjacent structures. METHODS: Magnetic resonance images of the lower extremities were acquired from five subjects after bilateral rectus femoris tendon transfer. A three-dimensional computer model of the musculoskeletal geometry of each of the ten limbs was created from these images. RESULTS: The three-dimensional paths of the rectus femoris muscles after transfer demonstrated that the muscle does not follow a straight course from its origin to its new insertion. The typical muscle-tendon path included an angular deviation; this deviation was sharp (>35 degrees ) in seven extremities. In addition, scar tissue between the transferred rectus femoris and the underlying muscles was visible on the magnetic resonance images. CONCLUSIONS: The angular deviations in the rectus femoris muscle-tendon path and the presence of scar tissue between the rectus femoris and the underlying muscles suggest that the beneficial effects of rectus femoris tendon transfer are derived from reducing the effects of the rectus femoris muscle as a knee extensor rather than from converting the muscle to a knee flexor. These findings clarify our understanding of the mechanism by which rectus femoris tendon transfer improves knee flexion. 相似文献
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Background
The rate of infection control for one-stage revision of infected knee arthroplasties is unclear as are the factors influencing infection control. Such factors include duration of infection and the type of infected prosthesis. 相似文献15.
Lin MM Goldsmith JD Resch SC DeAngelis JP Ramappa AJ 《Clinical orthopaedics and related research》2012,470(5):1452-1460
Background
Many hospitals require all operative specimens be sent to pathologists for routine examination. Although previous studies indicate this practice increases medical cost, it remains unclear whether it alters patient management and whether it is cost-effective. 相似文献16.
To evaluate the outcome of hamstring lengthening and distal rectus femoris transfer, a retrospective study was performed comparing preoperative and postoperative gait analysis data from 16 children with neurologic involvement. Postoperatively, the timing of peak knee flexion during swing and the total arc of knee motion significantly improved. Hamstring range of motion and knee extension at terminal swing significantly improved, but stride length and gait velocity did not for the overall population. Patients who used braces postoperatively showed an improvement in stride length and velocity when wearing orthoses. This suggests that postoperative bracing may be needed in some patients to maximize the surgical outcome. 相似文献
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Background
Previous studies of minimal medial epicondylectomy for cubital tunnel syndrome included patients with mild disease, making it difficult to determine how much this procedure improved sensory and motor impairments in patients with moderate to severe disease. 相似文献18.
Nandi S Aghazadeh M Talmo C Robbins C Bono J 《Clinical orthopaedics and related research》2012,470(5):1436-1441
Background
Hip and knee arthroplasties are widely performed and vascular disease among patients having these procedures is common. Clopidogrel is a platelet inhibitor that decreases the likelihood of thrombosis. It may cause intraoperative and postoperative bleeding, but its discontinuation increases the risk of vascular events. There is currently no consensus regarding the best perioperative clopidogrel regimen that balances these concerns. 相似文献19.
The purpose of this study was to review knee kinematics following combined hamstring lengthening and rectus femoris transfer. Previous findings reported in the literature include kinematic changes in the magnitude of stance-phase maximum knee flexion, stance-phase minimum knee flexion (extension), and swing-phase maximum knee flexion; the timing of swing-phase maximum knee flexion and swing-phase minimum knee flexion (extension); and total knee excursion. Twenty-three children underwent bilateral (22) or unilateral (1) hamstring lengthening and rectus femoris transfer (45 knees) at the Shriners Hospitals for Children in Lexington, KY between January 1996 and December 2001. Sagittal knee kinematic data were obtained as part of a complete gait study accomplished before surgery and at 1 year after surgery. Values were compared using a paired t test method set at a p < .05 level to determine statistical significance. Changes were seen in the magnitude of stance-phase maximum knee flexion, stance-phase minimum knee flexion (extension), swing-phase maximum knee flexion, and swing-phase minimum knee flexion (extension); in the timing of swing-phase maximum knee flexion; and in total knee excursion. 相似文献
20.
Honsawek S Yuktanandana P Tanavalee A Saetan N Anomasiri W Parkpian V 《International orthopaedics》2012,36(5):981-985