Article

AIM: To examine the effect of femoral derotation osteotomy (FDO) on dimensionless
hip abductor moment during gait in children with cerebral palsy. METHODS: We
retrospectively analyzed data from independent ambulators within our database.
Postoperative visits 1 year (short-term) and at least 3 years (mid-term) were
analyzed. We estimated the coronal plane hip abductor moment arm based on
musculoskeletal modeling that accounted for anteversion and hip rotation.
RESULTS: There were 140 individuals with a short-term analysis (77 males, 63
females; age at surgery 9y 11mo [range 4y 5mo-17y 5mo]) and 29 with mid-term
analysis (15 males, 14 females; age at surgery 8y 7mo [range 4y 5mo-13y 1mo]). At
short-term, anteversion and internal hip rotation decreased 35 degrees and 13
degrees respectively, which increased median (IQR) moment arms from 20 (23) per
cent below normal to 2 (12) per cent above normal. Dimensionless mean hip
abductor moment remained unchanged at short-term. Mid-term anteversion did not
change but hip rotation increased 8 degrees and hip abductor moment increased to
0.040 (0.029). There was no change in pelvic and trunk obliquity, although hip
abductor strength increased and walking velocity decreased at mid-term.
INTERPRETATION: The unexpected lack of improvement in hip abductor moment from
pre- to short-term may be caused by gait compensations that unload the hip. The
increase in hip abductor moment beyond 3 years postoperatively underscores the
benefits of an FDO into adolescence for independent ambulating individuals with
cerebral palsy.
CI - (c) 2017 Mac Keith Press.

Langue : ANGLAIS