Predicting the outcome of adductor tenotomy

Cottalorda, J.; Gautheron, V.; Metton, G; Charmet, E.; Maatougui, K.; Chavrier, Y

doi:10.1007/s002640050281

Cited by 24 publications

(20 citation statements)

References 24 publications

(69 reference statements)

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“…Sharrard et al (1975) also found better results in younger patients, as did Onimus et al (1991), who considered that preventive surgery should be performed already at 2-3 years of life. On the other hand, we found no influence of age, which is in keeping with several other reports (Silver et al 1985, Cottalorda et al 1998, Turker and Lee 2000.…”

Section: Factors Influencing Outcomesupporting

confidence: 93%

“…Concerning type of CP and gait function, we found no significant effects on radiographic outcome, in agreement with Silver et al (1985) and Cottalorda et al (1998). Others have found less satisfactory results in severely retarded patients than in those with higher mental status (Banks and Green 1960), and better results in patients who were ambulatory or with walking potential (Kalen and Bleck 1985).…”

Section: Factors Influencing Outcomesupporting

confidence: 74%

“…According to Cottalorda et al (1998) and Silver et al (1985), the preoperative MP was the only predictor of outcome. Silver et al (1985) found that the preoperative MP in failures was 59% and in successes it was 39%, which is quite similar to our findings and to the figures of 43% and 33%, respectively, reported in the study of Turker and Lee (2000).…”

Section: Factors Influencing Outcomementioning

confidence: 99%

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Adductor tenotomy in spastic cerebral palsy

et al. 2005

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Background There is a risk of hip dislocation in children with spastic cerebral palsy. We evaluated the prophylactic effect of adductor tenotomy in patients with long-term follow-up.Patients and methods Our material comprised 78 patients (46 boys) with a mean age of 8 (2-17) years who underwent adductor tenotomy during the period 1986-1991. 40 patients had spastic diplegia and 38 had quadriplegia. For patients who had further hip surgery, follow-up was until the next hip operation. Those who had not undergone further surgery were invited to a follow-up examination. The migration percentage (MP) was measured on the preoperative and follow-up radiographs. The radiographic result was termed good if MP at follow-up was reduced or had increased less than 10%. The follow-up period was 10 (1.6-16) years, with a mean of 6 years for patients with later hip surgery and 13 years without such surgery.Results The clinical outcome was good in 51 cases, poor in 12, and uncertain in 15. The radiographic result was good in 39 of the 53 patients with radiographs available both preoperatively and at follow-up. The patients with good radiographic results had lower preoperative MP than those with poor results (MP 34% versus 49%) and lower preoperative acetabular index. The mean increase in MP (worst hip in each patient) was 1.9% per year, which is considerably less than that in nonoperated patients. Further hip surgery was necessary in 27 patients, because of increasing MP in 14 cases and for clinical reasons in 13. Interpretation Adductor tenotomy reduced the trend towards lateral displacement of the hip joints. The operation had a favorable outcome in approximately

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Section: Factors Influencing Outcomesupporting

confidence: 93%

Section: Factors Influencing Outcomesupporting

confidence: 74%

Section: Factors Influencing Outcomementioning

confidence: 99%

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Adductor tenotomy in spastic cerebral palsy

et al. 2005

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“…As a corollary to this, five other studies reported that a total of 70 out of 324 hips undergoing adductor release required further surgery for hip subluxation and were deemed to be failures of the initial procedure. 9,38,39,48,49 The radiographic outcome measures used to assess subluxation were Reimer's migration percentage, 9 the center-edge angle, 50 and the acetabular index. 10,38 Two studies reported an Annotation 639 overall improvement in Reimer's migration percentage after adductor surgery 9,38 but a third study found no difference in the migration percentage compared with a control group.…”

Section: Caution Interpreting Resultsmentioning

confidence: 99%

“…By rows, one can see which dimensions of disablement have been targeted for investigation and which types and how often outcomes have been measured. For example, the range of hip abduction after hip adductor release has been investigated six times in six different studies, 10,23,30,[37][38][39] and all six studies have shown improvement compared with the mean preoperative hip abduction measure. However, the confidence that can be placed in these data is low, as all but one of the studies are graded level IV+W, indicating that the studies do not have a control group and are weakly controlled against internal threats to validity.…”

Section: Organization and Interpretationmentioning

confidence: 99%

Effects of surgical adductor releases for hip subluxation in cerebral palsy: an AACPDM evidence report*

Stott

Piedrahita²

2004

Develop Med Child Neuro

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Hip

Cerebral Palsy

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The hip joint is the largest joint in the body and is the joint that causes the most problems both from a functional perspective and at the level of walking, sitting, and lying in children with cerebral palsy (CP). Hips in children with CP are normal at birth, and the problems develop slowly as the children grow and deform under the influence of abnormal forces caused by the CP. A second group of children with CP do not actually develop deformity; however, the infantile shape of their proximal femur does not resolve because there is not enough normal force present. In summary, these children develop contractures and increased abnormal forces that lead to dislocation and dysplasia, or alternatively, they fail to resolve the infantile torsional malalignment. After addressing the concerns of equinus contractures in children with CP, hip problems are the next main area of interest to orthopaedists treating these children. The treatment of hip problems has the largest literature base in the area of orthopaedic management of CP. A review of the abstract listings in the National Library of Medicine revealed 496 references published from 1963 to 2000 that address hip problems in children with CP. Although the literature is extensive, much of it does not include any standardized control or standardized radiographic measurements and has a poor description of specific patterns. A substantial body of this literature addresses the natural history of the problem of hip dysplasia, and its etiology has been fairly well understood. The evaluation of treatment outcomes suffers especially from poor categorization, poor standard evaluation procedures, and, most of all, very poor long-term follow-ups. Spastic HipsHip problems in children with CP first need to be divided by children's level of tone into either spastic children or those children who are hypotonic. The spastic (hypertonic) group should also include children with movement disorders such as athetosis and dystonia. The hypertonic hips can be subdivided further by the direction of the dysplasia or the abnormal force into posterosuperior, anterior, inferior and, additionally, by several contracture patterns that may be independent of or concurrent with dysplastic hips. These contracture patterns include windblown hips and hyperabducted hips. The hypotonic hips in children with CP are a little more diffuse and are harder to further categorize.

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Predicting the outcome of adductor tenotomy

Cited by 24 publications

References 24 publications

Adductor tenotomy in spastic cerebral palsy

Adductor tenotomy in spastic cerebral palsy

Effects of surgical adductor releases for hip subluxation in cerebral palsy: an AACPDM evidence report*

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