Anterior distal femoral hemiepiphysiodesis for knee flexion contracture in paediatric patients with neuromuscular disorders: A systematic review and meta- analysis.

BACKGROUND

This meta-analysis assesses the effectiveness of ADFH in the operative management of knee flexion contracture in children with neuromuscular disorders.

METHODS

The study included 218 patients and assessed 340 knees. Patients had a median age of 11 years (age range 4-17 years) at initial evaluation. The mean follow up time was 25 months.

RESULTS

Gait deviation index improved by 8.49 points following ADFH (95 % CI 4.82-12.15, p < 0.01). Minimum flexion angle saw an overall improvement of 20.61 degrees (95 % CI 15.8 - 26.04, p < 0.001). Knee flexion contracture had an overall improvement of 11.74 degrees across (95 % CI 10.14-13.33, p < 0.001). Popliteal angle improved by 15.59 degrees overall following ADFH (95 % CI 7.57-23.60), p < 0.01).

CONCLUSION

Orthopaedic operations are known to improve knee kinematics and clinical examination findings in neuromuscular disorder patients. ADFH is effective in improving passive and dynamic sagittal knee function.