Abstract
Full knee extension is essential for gait. Patients with cerebral palsy frequently
have extension deficits of different magnitudes, which compromise walking and even
standing up. The treatment of knee flexion contracture begins by addressing the spasticity
of the involved muscles and includes physical therapy. For structured extension deficits,
the treatment is surgical, using different techniques depending on the magnitude of
the contracture and the patient's age. Soft tissue techniques include functional hamstring
lengthening and muscle transfers. For capsular contracture, bone surgery is preferable
and extends the proximal femur either progressively, through anterior physiodesis
in pediatric patients, or acutely, by extensor distal femoral osteotomy. A high patella
is common and requires correction during the same surgical procedure to maintain the
efficiency of the extensor apparatus.
Keywords
cerebral palsy - knee - contracture - gait - diplegia - hamstrings - high patella
