Differences in implementation of gait analysis recommendations based on affiliation with a gait laboratory.

Area of Science:

• Orthopedics
• Biomechanics
• Pediatric Surgery

Background:

• Gait analysis is crucial for planning orthopedic surgery in patients with cerebral palsy.
• Understanding surgeon adherence to gait analysis recommendations is vital for optimizing treatment outcomes.
• Surgeon affiliation with gait laboratories may influence the utilization of gait analysis findings.

Purpose of the Study:

• To evaluate the adherence of orthopedic surgeons to gait analysis recommendations.
• To determine if the degree of surgeon affiliation with a gait laboratory impacts adherence.
• To assess the influence of gait analysis on surgical decision-making in cerebral palsy patients.

Main Methods:

• Retrospective review of surgical data for 95 cerebral palsy patients undergoing lower extremity orthopedic surgery.
• Categorization of surgeons into direct affiliation, institutional affiliation, and no affiliation groups.
• Calculation of adherence rates based on gait analysis recommendations versus actual surgical procedures.

Main Results:

• Overall adherence to gait analysis recommendations was high (97% direct, 94% institutional, 77% no affiliation).
• Surgeons with direct or institutional affiliation showed higher rates of adding recommended procedures and dropping recommended procedures.
• Gait analysis recommendations led to surgical plan modifications in 84% of cases with pre-existing plans.

Conclusions:

• Gait analysis significantly influences orthopedic surgical decisions for cerebral palsy patients.
• Surgeon affiliation, particularly within the same institution, correlates with stronger adherence to gait analysis recommendations.
• Findings support the integration of gait analysis into the pre-operative planning process for improved surgical outcomes.