Knee surveillance for ambulant children with cerebral palsy

• DOI: 10.1177/18632521251330448
• Publication Date: 2025-04-15T18:27:17Z
• Authors: Pam Thomason; Kerr Graham; Ken Ye; Annette O’Donnell; Vedant Kulkarni; Jon R. Davids; Erich Rutz
• Keywords: Sitting

Purpose: A majority of ambulant children with cerebral palsy (CP) develop progressive musculoskeletal pathology (MSP) during growth. Fixed flexion deformity at the knee joint (FFDKn) contributes to flexed gait and is prone relapse after index multi-level surgery. This perspective introduces concept “knee surveillance” (KS), defined as a repeated systematic assessment range motion until skeletal maturity. KS aims detect early FFDKn, allowing for intervention minimally invasive techniques such anterior distal femur hemiepiphysiodesis (ADFH), reduce need higher-risk surgery femoral extension osteotomy (DFEO) patellar tendon shortening (PTS). Methods: Recent literature on CP, consensus statements indications dose-based surgery, ADFH have been reviewed synthesized. These provide preliminary evidence base in CP. Conclusion: We propose The goals are detection deformity, intervention, less better long-term outcomes. There suggest that soft-tissue combination ADFH, can reduce, or perhaps replace, more DFEO PTS. Level evidence: IV.