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Percutaneous Versus Open Hamstring Lengthening in Spastic Diplegic Cerebral Palsy
Javad Khaje Mozafari1,2, Karim Pisoudeh1,2, Kave Gharanizade1,2
1Bone and Joint Reconstruction Research Center, Shafa Orthopaedic Hospital, Iran University of Medical Sciences, Tehran, Iran.
The Archives of Bone and Joint Surgery
|August 27, 2019
Summary
Percutaneous hamstring lengthening (HSL) is as effective as open HSL for children with spastic diplegia, offering shorter hospital stays and lower costs. Further long-term studies are needed to generalize findings.
Area of Science:
- Orthopedics
- Pediatric Surgery
- Neurology
Background:
- Spastic diplegia often requires hamstring lengthening to improve gait and posture.
- Open hamstring lengthening (oHSL) is a common surgical approach.
- Percutaneous hamstring lengthening (pHSL) is an emerging alternative.
Purpose of the Study:
- To compare the efficacy and safety of pHSL versus oHSL.
- To evaluate outcomes in children with spastic diplegia undergoing hamstring lengthening.
Main Methods:
- Retrospective study of 54 patients (108 knees) with spastic diplegia.
- Comparison between open hamstring lengthening (oHSL) and percutaneous hamstring lengthening (pHSL).
- Analysis of pre- and post-operative popliteal angles and Gross Motor Function Class Scores.
Main Results:
- Both oHSL and pHSL significantly improved popliteal angles and Gross Motor Function Class Scores.
- No significant differences in efficacy were found between the two surgical approaches (P=0.83).
- pHSL resulted in significantly shorter hospital stays (1.6 vs 3.6 days, P=0.001) and lower costs ($333 vs $473, P=0.001).
- Complication rates were similar between the groups (P=0.85).
Conclusions:
- Percutaneous hamstring lengthening (pHSL) is a safe and effective alternative to open hamstring lengthening (oHSL).
- pHSL offers advantages in terms of reduced hospital stay and cost.
- Longer follow-up studies are recommended to validate these findings.
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