SHERP

Influence of surgery involving tendons around the knee joint on ankle motion during gait in patients with cerebral palsy

Cited 0 time in webofscience Cited 0 time in scopus
Authors
Lee, Seung Yeol; Kwon, Soon-Sun; Chung, Chin Youb; Lee, Kyoung Min; Sung, Ki Hyuk; Kim, Sangwoo; Park, Moon Seok
Issue Date
2018-03-15
Publisher
BioMed Central
Citation
BMC Musculoskeletal Disorders, 19(1):82
Keywords
Cerebral palsyGait analysisAnkle kinematicsDistal hamstring lengtheningRectus femoris transfer
Abstract
Background
Simultaneous motion of the knee and ankle joints is required for many activities including gait. We aimed to evaluate the influence of surgery involving tendons around the knee on ankle motion during gait in the sagittal plane in cerebral palsy patients.

Methods
We included data from 55 limbs in 34 patients with spastic cerebral palsy. Patients were followed up after undergoing only distal hamstring lengthening with or without additional rectus femoris transfer. The patients’ mean age at the time of knee surgery was 11.2 ± 4.7 years, and the mean follow-up duration was 2.2 ± 1.5 years (range, 0.9–6.0 years). Pre- and postoperative kinematic variables that were extracted from three-dimensional gait analyses were then compared to assess changes in ankle motion after knee surgery. Outcome measures included ankle dorsiflexion at initial contact, peak ankle dorsiflexion during stance, peak ankle dorsiflexion during swing, and dynamic range of motion of the ankle. Various sagittal plane knee kinematics were also measured and used to predict ankle kinematics. A linear mixed model was constructed to estimate changes in ankle motion after adjusting for multiple factors.

Results
Improvement in total range of motion of the knee resulted in improved motion of the ankle joint. We estimated that after knee surgery, ankle dorsiflexion at initial contact, peak ankle dorsiflexion during stance, peak ankle dorsiflexion during swing, and dynamic range of motion of the ankle decreased, respectively, by 0.4° (p = 0.016), 0.6° (p < 0.001), 0.2° (p = 0.038), and 0.5° (p = 0.006) per degree increase in total range of motion of the knee after either knee surgery. Furthermore, dynamic range of motion of the ankle increased by 0.4° per degree increase in postoperative peak knee flexion during swing.

Conclusions
Improvement in total knee range of motion was found to be correlated with improvement in ankle kinematics after surgery involving tendons around the knee. As motion of the knee and ankle joints is cross-linked, surgeons should be aware of potential changes in the ankle joint after knee surgery.
ISSN
1471-2474
Language
English
URI
http://hdl.handle.net/10371/139680
DOI
https://doi.org/10.1186/s12891-018-2003-0
Files in This Item:
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Orthopedic Surgery (정형외과학전공)Journal Papers (저널논문_정형외과학전공)
  • mendeley

Items in S-Space are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse