Knee pain and crouch gait in individuals with cerebral palsy: what impact does crouch-related surgery have?

Abstract

To investigate the effect of crouch-related surgery on knee pain in individuals with cerebral palsy. We retrospectively identified individuals with two three-dimensional gait analyses at baseline and follow-up visits. All individuals walked in crouch gait at baseline. Visits were 9months to 42months apart. Baseline knee pain, age, crouch-related surgery (yes/no), and minimum knee flexion at follow-up were entered into a logistic regression to predict follow-up knee pain. Thirty-two individuals (21 males, 11 females; mean [SD] age 12y 10mo [2y 5mo]; 8y 1mo-18y 7mo) received crouch-related surgery, while 19 were managed non-surgically. At baseline, knee pain prevalence was 38% in the surgical group and 21% in the non-surgical group. At follow-up, 34% of the surgical group and 16% of the non-surgical group had knee pain (odds ratio: 2.809, p=0.285). Crouch-related surgery does not appear to decrease knee pain prevalence compared to a comparison group, based on this preliminary study. Further investigation of the roles of these procedures is indicated with regards to this patient-reported outcome. What this paper adds Approximately 38% of individuals undergoing crouch-related surgery had knee pain. Approximately 42% of individuals with baseline knee pain who had surgery still had knee pain 1year postoperatively. Approximately 50% of those with baseline knee pain managed non-surgically still had knee pain 1year later. Crouch-related surgery tended not to decrease knee pain prevalence 1 year postoperatively.