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Late knee problems in myelomeningocele
J J Williams1, G P Graham, K B Dunne
1Central Texas Pediatric Orthopaedics and Scoliosis Surgery, Austin.
Journal of Pediatric Orthopedics
|November 1, 1993
Summary
Myelomeningocele patients often develop knee problems due to a specific gait pattern, leading to instability and degeneration. These knee issues are likely to hinder independent ambulation in affected individuals.
Area of Science:
- Orthopedics
- Neurology
- Rehabilitation Medicine
Background:
- Myelomeningocele (spina bifida) is a complex congenital condition affecting neurological and musculoskeletal function.
- Long-term complications in community-ambulating myelomeningocele survivors require ongoing investigation.
Purpose of the Study:
- To determine the incidence and causes of knee problems in a long-term follow-up of myelomeningocele patients.
- To identify specific gait characteristics associated with knee pathology in this population.
Main Methods:
- A cohort of 72 community ambulators with myelomeningocele underwent long-term follow-up.
- Assessment included clinical evaluation of knee symptoms and gait analysis.
Main Results:
- 17 out of 72 (24%) patients experienced significant knee symptoms.
- A distinct gait pattern was observed in symptomatic patients with low lumbar lesions, linked to hip abductor and calf muscle weakness.
- This gait pattern imposes abnormal stress on the knee, causing medial and anteromedial rotary instability and degenerative changes.
Conclusions:
- Knee problems are a common and significant issue in long-term myelomeningocele survivors.
- Specific gait abnormalities contribute to knee pathology, potentially leading to disability.
- Knee-related disability is a likely factor limiting independent ambulation in this patient group.