Proximal femoral varus rotation osteotomy in cerebral palsy: a prospective gait study.
This prospective study examined the kinematic and temporal/spatial effects of proximal femoral varus rotation osteotomy (VRO) on the gait of individuals with cerebral palsy from preoperative to 1-year postoperative status. Participants were a consecutive sample of 37 individuals (14 males, 23 females). The analysis consisted of three-dimensional kinematics, temporal/spatial measures, and functional status. A curve representing the difference between the preoperative and 12-month postoperative conditions was calculated for each joint motion. Ninety-five percent confidence intervals were calculated about the mean difference curves using a bootstrapping technique. VRO resulted in improved cosmesis and objective improvement in gait, including a statistically significant increase in hip external rotation and hip extension, a decrease in anterior pelvic tilt, and an increase in knee extension strength. The use of confidence bands to identify surgical outcomes with respect to kinematic variables has enormous value for patients and professionals. Long-term follow-up is needed to see if the aforementioned gains improve.
Hospital For Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
Mary
M
Murray-Weir
Leon
L
Root
Margaret
M
Peterson
Mark
M
Lenhoff
Laurence
L
Daly
Cathi
C
Wagner
Patricia
P
Marcus
D000293:Adolescent; D000843:Ankle Joint / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005684:Gait; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D010027:Osteotomy / Q000379:methods*