Biomechanical assessment of patellar tendon advancement in patients with cerebral palsy and crouch gait

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dc.authorid0000-0002-1861-9368
dc.contributor.authorKarabulut, Derya
dc.contributor.authorArslan, Yunus Ziya
dc.contributor.authorSalami, Firooz
dc.contributor.authorWolf, Sebastian
dc.contributor.authorGötze, Marco
dc.date.accessioned2022-01-12T07:43:07Z
dc.date.available2022-01-12T07:43:07Z
dc.date.issued2021
dc.departmentTAÜ, Fen Bilimleri Enstitüsü, Robotlar ve Akıllı Sistemler Ana Bilim Dalı Koleksiyonuen_US
dc.description.abstractBackground: Patellar height is a valuable measure to evaluate the effect of patellar tendon advancement (PTA) on knee function. In the literature, there is no validated procedure to measure the patellar height. In this study we aimed to (1) determine the patella position through musculoskeletal modeling, (2) investigate the effects of two surgical procedures applied for PTA, and (3) assess the effect of PTA in combination with single-event multilevel surgery (SEMLS) on the knee kinematics of patients with cerebral palsy (CP) and crouch gait. Method: Three-dimensional gait and X-ray data of children with CP and crouch gait were retrospectively analyzed if they had received a SEMLS in combination with PTA (PTA group, n = 18) or without PTA (NoPTA group, n = 18). A computational musculoskeletal model was used to quantify patella position, knee extension moment arm, and knee kinematics pre and postoperatively. Results: Patellar height significantly decreased in the PTA group (P = 0.004), while there was no difference in the NoPTA group (P > 0.05). The bony procedure for PTA provided a better Insall-Salvati ratio than the soft tissue procedure. The peak knee extension moment arm significantly increased in the PTA group (P = 0.008). In terms of postoperative knee joint kinematics, the PTA group was closer to typically developed children than the NoPTA group. Conclusion: Musculoskeletal modeling was found to be an effective tool for the determination of the patellar height. PTA improved the patella position, knee extension moment arm, and knee kinematics and was an effective procedure for the surgical management of crouch gait in patients with CP. (c) 2021 Elsevier B.V. All rights reserved.
dc.identifier.citationKarabulut, D., Arslan, Yunus Z., Salami, F., Wolf, S. I., & Götze, M. (2021). Biomechanical assessment of patellar tendon advancement in patients with cerebral palsy and crouch gait. The Knee, 32, 46-55.
dc.identifier.doi10.1016/j.knee.2021.07.010
dc.identifier.endpage55en_US
dc.identifier.issn0968-0160
dc.identifier.issn1873-5800
dc.identifier.scopus2-s2.0-85112745903
dc.identifier.scopusqualityQ2
dc.identifier.startpage46en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12846/628
dc.identifier.volume32en_US
dc.identifier.wosWOS:000702862000006
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.institutionauthorArslan, Yunus Ziya
dc.language.isoen
dc.publisherElsevier
dc.relation.ispartofKnee
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectCerebral Palsyen_US
dc.subjectSerebral Palsien_US
dc.subjectZerebralpareseen_US
dc.subjectPatellar Tendon Advancementen_US
dc.subjectPatellar Tendon Gelişimien_US
dc.subjectPatellasehnenfortschritten_US
dc.subjectCrouch Gaiten_US
dc.subjectPatella Positionen_US
dc.subjectMusculoskeletal Modelingen_US
dc.subjectHocke Gangen_US
dc.subjectPatellapositionen_US
dc.subjectMuskel Skelett Modellierungen_US
dc.subjectÇömelme Yürüyüşüen_US
dc.subjectPatella Pozisyonuen_US
dc.subjectKas-İskelet Modellemeen_US
dc.titleBiomechanical assessment of patellar tendon advancement in patients with cerebral palsy and crouch gait
dc.typeArticle

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