Management of the knee problems in spastic cerebral palsy

Dhiren Ganjwala, Hitesh Shah

Research output: Contribution to journalArticle

Abstract

Two common knee problems in cerebral palsy are increased knee flexion during stance phase and reduced knee flexion during the swing phase of gait. We reviewed the recent literature and based on that, we formed this review. Hamstring spasticity, quadriceps weakness, soleus weakness, and lever-arm dysfunction are few factors which lead to increased knee flexion during stance phase. Rectus spasticity diminishes knee flexion in the swing. Resulting gait-stiff knee gait interferes with ground clearance. Both gait patterns result into esthetically poor gait and increased energy consumption. Knee flexion gait may lead to pain in the knee. Natural history of knee flexion gait suggests deterioration over time. In the early stage, these gait abnormalities are managed by nonoperative treatment. Cases in which nonoperative measures fail or advance cases need surgical treatment. Various variables which are taken into consideration before selecting a particular treatment option are described. We also present an algorithm for decision-making. Nonsurgical options and surgical procedures are discussed.

Original languageEnglish
Pages (from-to)53-62
Number of pages10
JournalIndian Journal of Orthopaedics
Volume53
Issue number1
DOIs
Publication statusPublished - 01-01-2019

Fingerprint

Cerebral Palsy
Gait
Knee
Natural History
Decision Making
Arm
Therapeutics
Pain

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine

Cite this

@article{6a4ec166baa146299872384ee5398476,
title = "Management of the knee problems in spastic cerebral palsy",
abstract = "Two common knee problems in cerebral palsy are increased knee flexion during stance phase and reduced knee flexion during the swing phase of gait. We reviewed the recent literature and based on that, we formed this review. Hamstring spasticity, quadriceps weakness, soleus weakness, and lever-arm dysfunction are few factors which lead to increased knee flexion during stance phase. Rectus spasticity diminishes knee flexion in the swing. Resulting gait-stiff knee gait interferes with ground clearance. Both gait patterns result into esthetically poor gait and increased energy consumption. Knee flexion gait may lead to pain in the knee. Natural history of knee flexion gait suggests deterioration over time. In the early stage, these gait abnormalities are managed by nonoperative treatment. Cases in which nonoperative measures fail or advance cases need surgical treatment. Various variables which are taken into consideration before selecting a particular treatment option are described. We also present an algorithm for decision-making. Nonsurgical options and surgical procedures are discussed.",
author = "Dhiren Ganjwala and Hitesh Shah",
year = "2019",
month = "1",
day = "1",
doi = "10.4103/ortho.IJOrtho_339_17",
language = "English",
volume = "53",
pages = "53--62",
journal = "Indian Journal of Orthopaedics",
issn = "0019-5413",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "1",

}

Management of the knee problems in spastic cerebral palsy. / Ganjwala, Dhiren; Shah, Hitesh.

In: Indian Journal of Orthopaedics, Vol. 53, No. 1, 01.01.2019, p. 53-62.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Management of the knee problems in spastic cerebral palsy

AU - Ganjwala, Dhiren

AU - Shah, Hitesh

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Two common knee problems in cerebral palsy are increased knee flexion during stance phase and reduced knee flexion during the swing phase of gait. We reviewed the recent literature and based on that, we formed this review. Hamstring spasticity, quadriceps weakness, soleus weakness, and lever-arm dysfunction are few factors which lead to increased knee flexion during stance phase. Rectus spasticity diminishes knee flexion in the swing. Resulting gait-stiff knee gait interferes with ground clearance. Both gait patterns result into esthetically poor gait and increased energy consumption. Knee flexion gait may lead to pain in the knee. Natural history of knee flexion gait suggests deterioration over time. In the early stage, these gait abnormalities are managed by nonoperative treatment. Cases in which nonoperative measures fail or advance cases need surgical treatment. Various variables which are taken into consideration before selecting a particular treatment option are described. We also present an algorithm for decision-making. Nonsurgical options and surgical procedures are discussed.

AB - Two common knee problems in cerebral palsy are increased knee flexion during stance phase and reduced knee flexion during the swing phase of gait. We reviewed the recent literature and based on that, we formed this review. Hamstring spasticity, quadriceps weakness, soleus weakness, and lever-arm dysfunction are few factors which lead to increased knee flexion during stance phase. Rectus spasticity diminishes knee flexion in the swing. Resulting gait-stiff knee gait interferes with ground clearance. Both gait patterns result into esthetically poor gait and increased energy consumption. Knee flexion gait may lead to pain in the knee. Natural history of knee flexion gait suggests deterioration over time. In the early stage, these gait abnormalities are managed by nonoperative treatment. Cases in which nonoperative measures fail or advance cases need surgical treatment. Various variables which are taken into consideration before selecting a particular treatment option are described. We also present an algorithm for decision-making. Nonsurgical options and surgical procedures are discussed.

UR - http://www.scopus.com/inward/record.url?scp=85061370453&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061370453&partnerID=8YFLogxK

U2 - 10.4103/ortho.IJOrtho_339_17

DO - 10.4103/ortho.IJOrtho_339_17

M3 - Article

VL - 53

SP - 53

EP - 62

JO - Indian Journal of Orthopaedics

JF - Indian Journal of Orthopaedics

SN - 0019-5413

IS - 1

ER -