CEREBRAL PALSYPredictors of outcome of distal rectus femoris transfer surgery in ambulatory children with cerebral palsyRethlefsen, Susan A.a; Kam, Galend; Wren, Tishya A.L.a b c; Kay, Robert M.a b Author Information aChildrens Orthopaedic Center, Childrens Hospital Los Angeles bDepartment of Orthopaedic Surgery, Keck School of Medicine cDepartments of Radiology and Biomedical Engineering, University of Southern California, Los Angeles, California dCastle Medical Center, Kailua, Hawaii, USA Correspondence to Susan A. Rethlefsen, PT, Childrens Orthopaedic Center, Childrens Hospital Los Angeles, 4650 Sunset Boulevard, MS 69, Los Angeles, CA 90027, USA Tel: +1 323 361 4120; fax: +1 323 666 4409; e-mail: [email protected] The study was conducted at the Childrens Hospital Los Angeles, Los Angeles, California, USA Journal of Pediatric Orthopaedics B 18(2):p 58-62, March 2009. | DOI: 10.1097/BPB.0b013e3283298981 Buy Metrics Abstract The objective of this study was to identify the predictors of outcome of distal rectus femoris transfer in cerebral palsy. Preoperative and postoperative gait data for 81 patients were examined, focusing on knee flexion/extension range. Outcome was ‘good’ for 46 patients and ‘poor’ for 35. The poor outcome group had no improvement in knee range because of increased crouch postoperatively. Outcome was unrelated to quadriceps strength, crouch, velocity, or type of cerebral palsy. Gross Motor Function Classification System was predictive of outcome, with poor results in all level IV patients (P≤0.008). In conclusion, Gross Motor Function Classification System IV patients may not benefit from distal rectus femoris transfer because of increased postoperative crouch. © 2009 Lippincott Williams & Wilkins, Inc.