LATE KNEE PROBLEMS IN MYELOMENINGOCELE

This study was undertaken to assess the incidence and etiology of knee problems in a long-term follow-up of myelomeningocele patients. Of th e 72 community ambulators reviewed, 17 (24%) had significant knee symp toms. A specific gait pattern was identified in symptomatic patients w ith low lumbar lesions, which may be explained on the basis of hip abd uctor and calf muscle weakness. These patients have a characteristic g ait, which places abnormal stress on the knee, leading to medial and a nteromedial rotary instability and eventual degenerative change. It is likely that disability resulting from knee symptoms will be the facto r precluding independent ambulation in the patients reviewed in this s tudy.