Multiscale finite element musculoskeletal model for intact knee dynamics.

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Abstract

[Indexed for MEDLINE] 19. Arch Orthop Trauma Surg. 2022 Sep;142(9):2131-2138. doi: 10.1007/s00402-021-03797-0. Epub 2021 Feb 23. Long-term follow-up after multilevel surgery in cerebral palsy. Visscher R(#)(1), Hasler N(#)(2), Freslier M(3), Singh NB(2), Taylor WR(2), Brunner R(3)(4), Rutz E(3)(5)(4). Author information: (1)Laboratory for Movement Biomechanics, Institute for Biomechanics, ETH Zurich, HCP H16.1, Leopold-Ruzicka-Weg 4, 8093, Zurich, Switzerland. rosa.visscher@hest.ethz.ch. (2)Laboratory for Movement Biomechanics, Institute for Biomechanics, ETH Zurich, HCP H16.1, Leopold-Ruzicka-Weg 4, 8093, Zurich, Switzerland. (3)Laboratory of Movement Analysis, University Children's Hospital Basel (UKBB), Spitalstrasse 33, 4056, Basel, Switzerland. (4)Faculty of Medicine, The University of Basel, 4001, Basel, Switzerland. (5)Murdoch Children's Research Insitute, Pediatric Orthopedic Department, The University of Melbourne, The Royal Children's Hospital RCH, 50 Flemington Road, Parkville, Melbourne, 3052, Australia. (#)Contributed equally INTRODUCTION: Single-event multilevel surgery (SEMLS) is frequently used to correct pathological gait patterns in children with bilateral spastic cerebral palsy (BSCP) in a single session surgery. However, in-depth long-term evaluation reports of gait outcomes are limited. Therefore, we investigated if SEMLS is able to correct lower extremity joint and pelvic angles during gait towards typically developing gait patterns (TDC) in children with BSCP, and if so, if this effect is durable over a 10-year period. MATERIALS AND METHODS: In total 13 children with BSCP GMFCS level II at time of index-surgery between the ages of 7.7-18.2 years at the time of SEMLS were retrospectively recruited. Three-dimensional gait data were captured preoperatively, as well as at short-, mid-, and long-term post-operatively, and used to analyze: movement analysis profile (MAP), gait profile score (GPS), and lower extremity joint and pelvic angles over the course of a gait cycle using statistical parametric mapping. RESULTS: In agreement with previous studies, MAP and GPS improved towards TDCs after surgery, as did knee extension during the stance phase (ɳ2 = 0.67; p