Rectus femoris transfer

Rectus femoris transfer

Rectus femoris muscleOriginAnterior Inferior Iliac Spine and Ilium above toe acetabulum

InsertionQuadriceps tendon to base of patella and onto tibial tuberosity via the patellar tendonNerve to muscleFemoral nerve (L2-L4)

Stiff knee gait

One of m/c gait abnormality in patients with spastic CP

Typical findingDecreased ROM of knee during swing phaseFoot clearance problemReduced gait velocityReduced step length

Rectus femoris transferConventional treatment IndicationPositive Duncan-Ely sign

Gait analysis

Decreased knee flexion in swingDecreased and delayed peak knee flexion in sweing

Dynamic electromyographyPathological increased activity of the rectus femoris muscleOP technique

Outcome

Keep the rectus as a hip flexorConvert the rectus into a knee flexor???Elimination of the rectus femoris activityStudy planPatients321 ptsFactors affecting the results of RFTAgeGenderAnatomical typeFunctional scale (GMFCS level)SEMLS concomitant with RFT

Long term resultsLMM?Gait analysis (knee sagittal motion)GDI

MRI study SNUBH

Isokinetic muscle strength

Isometric muscle strengthHip Flexion/extensionAdduction/abductionKneeFlexion/extensionAnkleDorsiflexion/plantarflexionInversion/eversionThank you!!