Hamstring tenotomies in cerebral palsy: long-term retrospective analysis

Area of Science:

• Orthopedic surgery
• Pediatric neurology
• Rehabilitation medicine

Background:

• Cerebral palsy (CP) often involves hamstring muscle spasticity, impacting mobility.
• Limited range of motion and gait abnormalities are common challenges in CP patients.
• Surgical interventions aim to improve motor function and functional independence.

Purpose of the Study:

• To evaluate the long-term effectiveness of hamstring tenotomy in cerebral palsy patients.
• To assess the impact of the surgical procedure on range of motion and functional mobility.
• To investigate the incidence and resolution of potential surgical side effects like recurvatum.

Main Methods:

• A retrospective study followed 117 cerebral palsy patients post-hamstring tenotomy.
• The surgical technique involved proximal semimembranosus and distal semitendinosus and biceps femoris release.
• Range of motion, functional activity levels, and recurvatum were assessed over a mean follow-up of 3.4 years.

Main Results:

• Significant improvements in range of motion were observed at 1 year and sustained for 4 years post-surgery.
• Thirty percent of previously nonambulatory patients demonstrated at least one level of functional improvement.
• Minor recurvatum was noted at 1 year but largely resolved by 3-5 years post-operation.

Conclusions:

• Hamstring tenotomy is an effective surgical option for improving range of motion in cerebral palsy.
• The procedure can lead to functional gains, including improved ambulation, in a subset of nonambulatory patients.
• Long-term follow-up indicates sustained benefits and minimal persistent side effects.