Our experience in the treatment of knee flexion contracture in cerebral palsy

Our experience in the treatment of knee flexion contracture in cerebral palsy

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Title:	Our experience in the treatment of knee flexion contracture in cerebral palsy
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Article_Title:	Our experience in the treatment of knee flexion contracture in cerebral palsy
Authors:	Alexandru Pop, Dan Fruja
Affiliation:	“Vasile Goldis” Western University of Arad, Romania, Department of Orthopaedics and Traumatology
Abstract:	Objectives: This study aimed to assess the results of surgical treatment for correcting knee flexion contractures (KFC) in cerebral palsy (CP). Methods: We reviewed 25 patients (15 boys and 10 girls, average age 14.2 years ) after 5.6 years (2-9 years).In all this cases (35 knees) we performed hamstring lengthening combined with posterior knee capsulotomy (30 cases), rectus femoris transfer (2 cases), patellar tendon plication (5 cases) and posterior cruciate ligament release (2 cases). Results: KFC significantly improved from 24 to 14 degrees. Popliteal angle improved from 65 to 46 degrees. The great majority of cases (75%) had a better ambulatory status. Complications included transient sciatic nerve palsy (5 cases), wound dehiscence (4 cases) and recurrent flexion contracture (7 cases). Conclusions: Surgical treatment is only a part of correction procedures in CP. Hamstring lengthening may be sufficient for the correction of KFC but is better to be associated with posterior capsulotomy to prevent recurrences. After operation is necessary a long rehabilitation program in specialized departments.
Keywords:	cerebral palsy, child, contracture, gait, knee joint/surgery
References:	Wilson PD. Posterior capsuloplasty in certain flexion contracture of the knee. J. Bone Joint Surg. [Am] 1929;11:40-58 Radulescu Al, Baciu C., Genunchiul , Bucuresti , Edit.Acad.RSR, 1965 , 379-388 Heydarian K.,Akbarnia B.A.,Jabalameli M.,Tabador K. Posterior capsulotomy for the treatment of severe flexion contractures of the knee.J. Pediatr.Orthop. 1984;4:700-4 Dhawlikar S.H., Root L.,Mann R.L. Distal lenghtening of the hamstrings in patients who have cerebral palsy. J.Bone Joint Surg. [Am] 1992;74:1385-91 Woratanarat P.,Dabney K.,Miller F. Knee capsulotomy for fixed knee flexion contracture. Acta Orthop.Traumat.Turc. 2009:43(2):121-127.
Read_full_article:	pdf/vol12/iss4/JMA12-4-09PopA.pdf
Correspondence:	Alexandru Pop, MD, PhD. Depart. of Orthopedics and Traumatology, “Vasile Goldis” Western University of Arad, 10A Triumfului, Arad, Romania, Email: alexanpop@yahoo.com

	Read full article
Article Title:	Our experience in the treatment of knee flexion contracture in cerebral palsy
Authors:	Alexandru Pop, Dan Fruja
Affiliation:	“Vasile Goldis” Western University of Arad, Romania, Department of Orthopaedics and Traumatology
Abstract:	Objectives: This study aimed to assess the results of surgical treatment for correcting knee flexion contractures (KFC) in cerebral palsy (CP). Methods: We reviewed 25 patients (15 boys and 10 girls, average age 14.2 years ) after 5.6 years (2-9 years).In all this cases (35 knees) we performed hamstring lengthening combined with posterior knee capsulotomy (30 cases), rectus femoris transfer (2 cases), patellar tendon plication (5 cases) and posterior cruciate ligament release (2 cases). Results: KFC significantly improved from 24 to 14 degrees. Popliteal angle improved from 65 to 46 degrees. The great majority of cases (75%) had a better ambulatory status. Complications included transient sciatic nerve palsy (5 cases), wound dehiscence (4 cases) and recurrent flexion contracture (7 cases). Conclusions: Surgical treatment is only a part of correction procedures in CP. Hamstring lengthening may be sufficient for the correction of KFC but is better to be associated with posterior capsulotomy to prevent recurrences. After operation is necessary a long rehabilitation program in specialized departments.
Keywords:	cerebral palsy, child, contracture, gait, knee joint/surgery
References:	Wilson PD. Posterior capsuloplasty in certain flexion contracture of the knee. J. Bone Joint Surg. [Am] 1929;11:40-58 Radulescu Al, Baciu C., Genunchiul , Bucuresti , Edit.Acad.RSR, 1965 , 379-388 Heydarian K.,Akbarnia B.A.,Jabalameli M.,Tabador K. Posterior capsulotomy for the treatment of severe flexion contractures of the knee.J. Pediatr.Orthop. 1984;4:700-4 Dhawlikar S.H., Root L.,Mann R.L. Distal lenghtening of the hamstrings in patients who have cerebral palsy. J.Bone Joint Surg. [Am] 1992;74:1385-91 Woratanarat P.,Dabney K.,Miller F. Knee capsulotomy for fixed knee flexion contracture. Acta Orthop.Traumat.Turc. 2009:43(2):121-127.
*Correspondence:	Alexandru Pop, MD, PhD. Depart. of Orthopedics and Traumatology, “Vasile Goldis” Western University of Arad, 10A Triumfului, Arad, Romania, Email: alexanpop@yahoo.com

Tags:cerebral palsy, child, contracture, gait, knee joint/surgery

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