RECTUS FEMORIS SURGERY IN CHILDREN WITH CEREBRAL-PALSY .2. A COMPARISON BETWEEN THE EFFECT OF TRANSFER AND RELEASE OF THE DISTAL RECTUS FEMORIS ON KNEE MOTION

Rectus femoris muscle (RF) surgery was performed in 98 children (136 s ides) with cerebral palsy (CP). RF transfer was performed in 105 lower limbs, and distal RF release was performed in 31. Eleven (20 sides) s imilarly affected children had no RF procedure and are included for co mparison. Gait analysis was performed just before and approximately 1 year after surgery. All children underwent other orthopaedic surgery a t the time of the RF procedure. When preoperative knee range of motion (ROM) was >80% of normal, there were no significant changes in knee m otion in either the RF transfer or distal release groups. In patients with <80% of normal knee ROM preoperatively, RF transfer was followed by maintained knee flexion in swing; patients who underwent distal RF release or no RF procedure showed a decrease (10-degrees and 6-degrees , respectively) in knee flexion postoperatively. These results suggest that the RF should be transferred and not released when knee ROM is < 80%.