The increase of anterior pelvic tilt after crouch gait treatment in patients with cerebral palsy

•The study compares 3 different approaches for crouch gait treatment.•The increase of anterior pelvic tilt was observed at all groups.•The increase of anterior pelvic tilt is a consequence of crouch gait treatment. The increase of anterior pelvic tilt (APT) has been described after the treatment of crouch gait in cerebral palsy (CP). The ideal treatment option for flexed knee gait in CP should provide knee extension improvement in the stance phase without generating the increase of APT. The purpose of this study was to compare three different approaches used for the treatment of crouch gait in CP [distal femur extension osteotomy (DFEO), patellar tendon shortening (PTS) and the combination of DFEO +PTS] regarding the increase of APT after the interventions. The inclusion criteria were: (1) diagnosis of spastic diplegic CP, (2) GMFCS levels I–III, (3) patients who underwent DFEO and/or PTS and (4) with complete documentation in the gait laboratory before and after the intervention. The included patients were divided into 3 groups, according to the procedures performed for crouch gait treatment: PTS (19 patients), DFEO (54 patients) and PTS + DFEO (22 patients). During stance phase, knee flexion decreased from 41.60 to 13.60 in the PTS group (p