دورية أكاديمية
أعرض في EDS

Comparison of the Results of Primary Versus Repeat Hamstring Surgical Lengthening in Cerebral Palsy.

التفاصيل البيبلوغرافية
العنوان: Comparison of the Results of Primary Versus Repeat Hamstring Surgical Lengthening in Cerebral Palsy.
المؤلفون: Morais Filho MC; Gait Laboratory and Cerebral Palsy Clinic., Blumetti FC; Gait Laboratory and Cerebral Palsy Clinic.; Association for the Care of Disabled Children, São Paulo, Brazil., Kawamura CM; Gait Laboratory.; Association for the Care of Disabled Children, São Paulo, Brazil., Fujino MH; Gait Laboratory and Cerebral Palsy Clinic.; Association for the Care of Disabled Children, São Paulo, Brazil., Matias MS; Association for the Care of Disabled Children, São Paulo, Brazil., Lopes JAF; Gait Laboratory.; Association for the Care of Disabled Children, São Paulo, Brazil.
المصدر: Journal of pediatric orthopedics [J Pediatr Orthop] 2020 May/Jun; Vol. 40 (5), pp. e380-e384.
نوع المنشور: Comparative Study; Journal Article; Comment
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8109053 Publication Model: Print Cited Medium: Internet ISSN: 1539-2570 (Electronic) Linking ISSN: 02716798 NLM ISO Abbreviation: J Pediatr Orthop Subsets: MEDLINE
أسماء مطبوعة: Publication: 2000- : Philadelphia : Lippincott Williams & Wilkins
Original Publication: New York Ny : Raven Press
مواضيع طبية MeSH: Gait* , Range of Motion, Articular* , Reoperation*, Cerebral Palsy/*surgery , Hamstring Muscles/*surgery , Hamstring Tendons/*surgery, Adolescent ; Biomechanical Phenomena ; Cerebral Palsy/complications ; Cerebral Palsy/physiopathology ; Child ; Contracture/etiology ; Contracture/surgery ; Female ; Gait Disorders, Neurologic/etiology ; Gait Disorders, Neurologic/physiopathology ; Humans ; Knee Joint/physiopathology ; Male ; Posture ; Recurrence ; Retrospective Studies ; Tenotomy ; Treatment Outcome
مستخلص: Background: Hamstring surgical lengthening (HSL) has been frequently performed for the correction of knee flexion deformity in cerebral palsy (CP), although recurrence is described in long-term follow-up. Repeat hamstring surgical lengthening (RHSL) can be an option for recurrent knee flexion deformity; however, the results of this approach are still controversial. The purpose of this study was to compare the results of primary HSL and RHSL in CP.
Methods: Patients with spastic diplegic CP, Gross Motor Function Classification System levels I to III, underwent bilateral medial HSL with complete documentation in the gait laboratory before and after the intervention, were included in the study. A total of 229 subjects met the inclusion criteria and were divided into 2 groups: group A was formed by those who received medial HSL for the first time (185 patients), and group B was composed of individuals who underwent RHSL (44 patients). Clinical and kinematic parameters were evaluated before and after the intervention, and the results compared.
Results: The groups were matched with regard to sex distribution, Gross Motor Function Classification System levels, and follow-up time (>2 y). Popliteal angle was reduced in groups A (60.3 to 51.4 degrees, P<0.001) and B (56.1 to 51.5 degrees, P=0.001) after the intervention. Knee flexion at initial contact was reduced from 40.8 to 28.9 degrees in group A (P<0.001) and from 40.4 to 35.1 degrees in group B (P=0.001). Reduction of minimum knee flexion in the stance phase (24.9 to 17.5 degrees, P<0.001) and improvement of the Gait Deviation Index (52.9 to 60.2, P<0.001) occurred only in group A. Anterior pelvic tilt (APT) increased in groups A (from 17 to 19.5 degrees, P<0.001) and B (from 14.9 to 19.4 degrees, P<0.001) after treatment. Finally, in the comparison between groups, the reduction of knee flexion at initial contact was more significant in group A (P<0.001), whereas the increase of APT was higher in group B.
Conclusions: In the present study, the improvement of knee extension during the stance phase was observed only after the primary medial HSL. Moreover, the increase of APT was more significant when RHSL was performed.
Level of Evidence: Level III.
التعليقات: Comment on: J Pediatr Orthop. 2020 Nov/Dec;40(10):e1024-e1025. (PMID: 32868516)
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SCR Disease Name: Cerebral palsy, spastic, diplegic
تواريخ الأحداث: Date Created: 20191106 Date Completed: 20201007 Latest Revision: 20210209
رمز التحديث: 20221213
DOI: 10.1097/BPO.0000000000001464
PMID: 31688817
قاعدة البيانات: MEDLINE
الوصف
تدمد:1539-2570
DOI:10.1097/BPO.0000000000001464