Comparison of rectus femoris transposition with traditional transfer for treatment of stiff knee gait in patients with cerebral palsy |
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Authors: | Yoram Hemo Michael D Aiona Rosemary A Pierce Robin Dorociak Michael D Sussman |
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Institution: | (1) Dana Children’s Hospital, Tel-Aviv Medical Center, Tel-Aviv, Israel;(2) Shriners Hospital for Children – Portland Unit, 3101 SW Sam Jackson Park Road, Portland, OR 97239, USA |
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Abstract: | 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. |
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Keywords: | Rectus femoris Cerebral palsy Gait analysis |
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