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

Aim To investigate the effect of crouch‐related surgery on knee pain in individuals with cerebral palsy. Method 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 9 months to 42 months 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. Results 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). Interpretation 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 1 year postoperatively. Approximately 50% of those with baseline knee pain managed non‐surgically still had knee pain 1 year later. Crouch‐related surgery tended not to decrease knee pain prevalence 1 year postoperatively. Resumen Dolor de rodilla y marcha en cuclillas en personas con parálisis cerebral: ¿qué impacto tiene la cirugía indicadas para esta deformidad? Objetivo Investigar el efecto de la cirugía relacionada con la marcha en cuclillas con el dolor de rodilla en personas con parálisis cerebral. Método Identificamos retrospectivamente a los individuos con dos análisis tridimensionales de la marcha al inicio y en las visitas de seguimiento. Todos los individuos caminaron en cuclillas al inicio del estudio. Las visitas fueron de 9 a 42 meses de diferencia. El dolor al inicio, edad, la cirugía relacionada con este tipo de marcha (sí / no) y la flexión mínima de la rodilla en el seguimiento, se ingresaron en una regresión logística para predecir el dolor de rodilla de seguimiento. Resultados Treinta y dos individuos (21 varones, 11 mujeres; media [DE] edad 12 años 10 meses [2 años 5 meses]; 8 años 1 mes – 18 años 7 meses) recibieron