Predictors of Changes in Pelvic Rotation after Surgery with or without Femoral Derotational Osteotomy in Ambulatory Children with Cerebral Palsy
Asymmetry of pelvic rotation affects function. However, predicting the post-operative changes in pelvic rotation is difficult as the root causes are complex and likely multifactorial. This retrospective study explored potential predictors of the changes in pelvic rotation after surgery with or witho...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-10-01
|
| Series: | Bioengineering |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2306-5354/10/10/1214 |
| _version_ | 1797574698032168960 |
|---|---|
| author | Reiko Hara Susan A. Rethlefsen Tishya A. L. Wren Robert M. Kay |
| author_facet | Reiko Hara Susan A. Rethlefsen Tishya A. L. Wren Robert M. Kay |
| author_sort | Reiko Hara |
| collection | DOAJ |
| description | Asymmetry of pelvic rotation affects function. However, predicting the post-operative changes in pelvic rotation is difficult as the root causes are complex and likely multifactorial. This retrospective study explored potential predictors of the changes in pelvic rotation after surgery with or without femoral derotational osteotomy (FDRO) in ambulatory children with cerebral palsy (CP). The change in the mean pelvic rotation angle during the gait cycle, pre- to post-operatively, was examined based on the type of surgery (with or without FDRO) and CP distribution (unilateral or bilateral involvement). In unilaterally involved patients, pelvic rotation changed towards normal with FDRO (<i>p</i> = 0.04), whereas patients who did not undergo FDRO showed a significant worsening of pelvic asymmetry (<i>p</i> = 0.02). In bilaterally involved patients, the changes in pelvic rotation did not differ based on FDRO (<i>p</i> = 0.84). Pelvic rotation corrected more with a greater pre-operative asymmetry (β = −0.21, SE = 0.10, <i>p</i> = 0.03). Sex, age at surgery, GMFCS level, and follow-up time did not impact the change in pelvic rotation. For children with hemiplegia, internal hip rotation might cause compensatory deviation in pelvic rotation, which could be improved with surgical correction of the hip. The predicted changes in pelvic rotation should be considered when planning surgery for children with CP. |
| first_indexed | 2024-03-10T21:26:00Z |
| format | Article |
| id | doaj.art-f4e420597fd5448ca2509d81b4f6bbc7 |
| institution | Directory Open Access Journal |
| issn | 2306-5354 |
| language | English |
| last_indexed | 2024-03-10T21:26:00Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Bioengineering |
| spelling | doaj.art-f4e420597fd5448ca2509d81b4f6bbc72023-11-19T15:42:37ZengMDPI AGBioengineering2306-53542023-10-011010121410.3390/bioengineering10101214Predictors of Changes in Pelvic Rotation after Surgery with or without Femoral Derotational Osteotomy in Ambulatory Children with Cerebral PalsyReiko Hara0Susan A. Rethlefsen1Tishya A. L. Wren2Robert M. Kay3Motion and Sports Analysis Laboratory, Jackie and Gene Autry Orthopedic Center, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USAMotion and Sports Analysis Laboratory, Jackie and Gene Autry Orthopedic Center, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USAMotion and Sports Analysis Laboratory, Jackie and Gene Autry Orthopedic Center, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USAMotion and Sports Analysis Laboratory, Jackie and Gene Autry Orthopedic Center, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USAAsymmetry of pelvic rotation affects function. However, predicting the post-operative changes in pelvic rotation is difficult as the root causes are complex and likely multifactorial. This retrospective study explored potential predictors of the changes in pelvic rotation after surgery with or without femoral derotational osteotomy (FDRO) in ambulatory children with cerebral palsy (CP). The change in the mean pelvic rotation angle during the gait cycle, pre- to post-operatively, was examined based on the type of surgery (with or without FDRO) and CP distribution (unilateral or bilateral involvement). In unilaterally involved patients, pelvic rotation changed towards normal with FDRO (<i>p</i> = 0.04), whereas patients who did not undergo FDRO showed a significant worsening of pelvic asymmetry (<i>p</i> = 0.02). In bilaterally involved patients, the changes in pelvic rotation did not differ based on FDRO (<i>p</i> = 0.84). Pelvic rotation corrected more with a greater pre-operative asymmetry (β = −0.21, SE = 0.10, <i>p</i> = 0.03). Sex, age at surgery, GMFCS level, and follow-up time did not impact the change in pelvic rotation. For children with hemiplegia, internal hip rotation might cause compensatory deviation in pelvic rotation, which could be improved with surgical correction of the hip. The predicted changes in pelvic rotation should be considered when planning surgery for children with CP.https://www.mdpi.com/2306-5354/10/10/1214pelvic rotationgait analysisfemoral derotational osteotomycerebral palsy |
| spellingShingle | Reiko Hara Susan A. Rethlefsen Tishya A. L. Wren Robert M. Kay Predictors of Changes in Pelvic Rotation after Surgery with or without Femoral Derotational Osteotomy in Ambulatory Children with Cerebral Palsy Bioengineering pelvic rotation gait analysis femoral derotational osteotomy cerebral palsy |
| title | Predictors of Changes in Pelvic Rotation after Surgery with or without Femoral Derotational Osteotomy in Ambulatory Children with Cerebral Palsy |
| title_full | Predictors of Changes in Pelvic Rotation after Surgery with or without Femoral Derotational Osteotomy in Ambulatory Children with Cerebral Palsy |
| title_fullStr | Predictors of Changes in Pelvic Rotation after Surgery with or without Femoral Derotational Osteotomy in Ambulatory Children with Cerebral Palsy |
| title_full_unstemmed | Predictors of Changes in Pelvic Rotation after Surgery with or without Femoral Derotational Osteotomy in Ambulatory Children with Cerebral Palsy |
| title_short | Predictors of Changes in Pelvic Rotation after Surgery with or without Femoral Derotational Osteotomy in Ambulatory Children with Cerebral Palsy |
| title_sort | predictors of changes in pelvic rotation after surgery with or without femoral derotational osteotomy in ambulatory children with cerebral palsy |
| topic | pelvic rotation gait analysis femoral derotational osteotomy cerebral palsy |
| url | https://www.mdpi.com/2306-5354/10/10/1214 |
| work_keys_str_mv | AT reikohara predictorsofchangesinpelvicrotationaftersurgerywithorwithoutfemoralderotationalosteotomyinambulatorychildrenwithcerebralpalsy AT susanarethlefsen predictorsofchangesinpelvicrotationaftersurgerywithorwithoutfemoralderotationalosteotomyinambulatorychildrenwithcerebralpalsy AT tishyaalwren predictorsofchangesinpelvicrotationaftersurgerywithorwithoutfemoralderotationalosteotomyinambulatorychildrenwithcerebralpalsy AT robertmkay predictorsofchangesinpelvicrotationaftersurgerywithorwithoutfemoralderotationalosteotomyinambulatorychildrenwithcerebralpalsy |