3D Gait Analysis and Patient-reported Outcomes of Femoral Osteotomies for Torsional Deformity

Hamid, Jehan; Do, Patrick; Bauer, Jeremy

doi:10.1097/bpo.0000000000002204

Cited by 5 publications

(4 citation statements)

References 35 publications

(93 reference statements)

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“…In FA, hip rotation allows neutral knee progression but results in relatively internal foot progression. This knee progression strategy correlates with the recent work by Hamid et al demonstrating the compensatory mechanism of increased internal hip rotation to optimize the abductor moment [11].…”

Section: Discussionsupporting

confidence: 87%

“…More recently, 3-dimensional motion analysis has provided increased insight into quantifying and characterizing these deformities [8][9][10][11]. Level walking at a self-selected speed may not exhibit large deviations from typically developing (TD) children due to compensatory mechanics, including hip rotation and alterations in ground reaction force loading to correct moments.…”

Section: Introductionmentioning

confidence: 99%

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Drop landing analysis of rotational osteotomies

Stevens,

Grothaus,

MacWilliams

2023

Journal of Pediatric Orthopaedics B

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Pathomechanics resulting from rotational deformities of the long bones in an idiopathic population have not been extensively studied, and are chiefly limited to level over ground walking. Thirty-five adolescents with excessive idiopathic outward tibial torsion (TT), femoral rotation, or both (pan genu) were studied both before and after corrective surgery. Data collected included computational motion analysis of a drop jump and patient-reported outcomes consisting of PODCI and Goal Attainment Scores. Results were compared to an age-matched typically developing cohort (n = 25). Subjects with femoral anteversion (FA) exhibited compensatory hip rotations to normalize knee progression angles at landing. Subjects with only TT did not compensate at the hip, landing with typical knee progression but excessive outward foot progression. These strategies resulted in elevated frontal plane knee moments for FA (P = 0.008), and elevated lateral knee forces in all groups compared to typical, with the TT group reaching significance (P < 0.001). Rotational osteotomies successfully restored elevated kinematics and kinetics to within or below typically developing ranges. Patient-reported outcomes generally improved after surgery across all domains studied. Drop jump testing elucidated compensation strategies employed by these cohorts. Compensation did not fully alleviate elevated forces at the knees. Surgical intervention normalized pathokinematics and pathokinetics, reduced pain, and improved patients’ perception of their functional abilities. Greater improvements were found in individuals in the two groups with FA compared to the group with TT only.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Drop landing analysis of rotational osteotomies

Stevens,

Grothaus,

MacWilliams

2023

Journal of Pediatric Orthopaedics B

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“…Hamid et al used the pediatric outcomes data collection instrument to investigate changes in PROMs following this procedure. 11 They noted improvements in transfer/basic mobility, sports/physical function, global functioning, and satisfaction with symptoms in their internal torsional deformity patients. In their external torsional deformity patients, they noted an improvement in satisfaction with symptoms after surgery.…”

Section: Discussionmentioning

confidence: 97%

Outcomes of percutaneous femoral derotational osteotomy in pediatric patients

Geffner

Ellsworth

Greenstein

et al. 2023

Journal of Children's Orthopaedics

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Background: Percutaneous femoral derotational osteotomies are performed in both adult and pediatric patients. There is little published on the outcomes after femoral derotational osteotomy in pediatric patients. Methods: A retrospective cohort study of pediatric patients treated with percutaneous femoral derotational osteotomy by one of two surgeons between 2016 and 2022 was performed. Data collected included patient demographics; surgical indications; femoral version; tibial torsion; magnitude of rotational correction; complications; time to hardware removal; pre-operative and post-operative patient-reported outcome scores, including Limb Deformity–Scoliosis Research Society and Patient-Reported Outcomes Measurement Information System; and time to consolidation. Descriptive statistics were used to summarize the data and t tests used to compare means. Results: Thirty-one femoral derotational osteotomies in 19 patients were included with an average age of 14.7 (9–17) years. The average rotational correction was 21.5° ± 6.4° (10°–40°). The average length of follow-up was 17.9 ± 6.7 months. There were no instances of nonunion, joint stiffness, or nerve injury. No patients returned to the operating room for additional surgeries other than routine hardware removal. There were no cases of avascular necrosis of the femoral head. Of the 19 patients, 8 completed both a pre-operative and post-operative survey set. There were significant improvements in the Limb Deformity–Scoliosis Research Society Self-Image/Appearance sub-category and the Patient-Reported Outcomes Measurement Information System Physical Function sub-category. Conclusion: Femoral derotational osteotomy using a percutaneous drill hole technique with antegrade trochanteric entry femoral nail is safe in the pediatric population and improves self-image in patients with symptomatic femoral version abnormalities.

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“…Hamid et al reported improved 3D gait analysis and Pediatric Outcomes Data Collection Instrument (PODCI) scores following surgical correction of femoral torsion in patients with internal and external femoral torsional deformities 30 . A survey of 461 surgeons using the Hospital for Special Surgery Knee Surgery Expectations Survey (HFSS-KSES) and a 10-item, non-validated questionnaire evaluated surgeons' expectations and compared these with patient expectations regarding the results of high tibial osteotomies 31 .…”

Section: Lower-extremity Deformitymentioning

confidence: 99%