Hamstring lengthening may increase anterior pelvic tilt among children with cerebral palsy
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Results showed hamstring lengthening may increase anterior pelvic tilt among ambulatory children with cerebral palsy.
Researchers recommend that the likely increased midterm anterior pelvic tilt postoperatively should be weighed with the desired outcome of improved knee extension prior to hamstring lengthening.
“Hopefully, children with cerebral palsy will have access to 3D motion analysis laboratories prior to undergoing multilevel surgeries to enhance their gait,” Alison Hanson, MS, PT, OCS, physical therapist with the Motion and Sports Analysis Lab at Children’s Hospital Los Angeles, told Healio about results presented at the Gait and Clinical Movement Analysis Society Annual Meeting where it received the best paper award. “Utilizing the information that we can glean from the 3D motion analysis, including the dynamic hamstring lengthenings, the correct or most appropriate surgeries will be prescribed going forward, avoiding less than optimal results in the future.”
Hanson and colleagues retrospectively reviewed mean pelvic tilt data for 44 children with cerebral palsy who underwent hamstring lengthening procedures. Researchers assessed pelvic tilt once prior to the hamstring lengthening procedure and twice after the procedure at a motion analysis laboratory.
Patients who underwent hamstring lengthening had significantly increased anterior pelvic tilt both at short-term and midterm follow-up, according to Hanson.
“Increased anterior pelvic tilt is not a normal progression of children with cerebral palsy over their life span,” Hanson said. “That does not normally happen. So we know that if it does happen, it is usually due to some intervention that was associated with trying to fix another component to their walking ability, in which case, this time, we had lengthened their hamstrings.”
Hanson also noted children who had longer dynamic hamstring length had an 80% correlation to anterior pelvic tilt position.
“It drills home the point that, in children who may need hamstring lengthening, surgeons need to get a modeled hamstring length that can be done in a 3D motion analysis lab because popliteal angle was only correlated about 50% to pelvic tilt, whereas the dynamic hamstring length is correlated 80% to pelvic tilt angle,” Hanson said.
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Hanson A, et al. Paper 21. Presented at: Gait and Clinical Movement Analysis Society Annual Meeting; June 7-8, 2022 (virtual).
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