Percutaneous Needle Technique is Comparable to Open Z-plasty Surgery for Unilateral Tendon Achilles Lengthening in Children With Cerebral Palsy

Completed

• Conditions: Cerebral Palsy; Equinus Foot Deformity in Children With Cerebral Palsy; Gait Analysis in Neurological Disorders

• Registration Number: NCT06875011
• Lead Sponsor: Vestre Viken Hospital Trust

Brief Summary

This study aims to compare the outcomes of two surgical techniques for Achilles tendon lengthening in ambulatory children with cerebral palsy (CP): the percutaneous needle technique and the traditional open Z-lengthening technique. The primary objective is to evaluate the effectiveness of these techniques in improving ankle dorsiflexion and gait function one year postoperatively. Secondary objectives include assessing postoperative complications, re-rupture rates, and patient satisfaction. The study is designed as a retrospective, matched-pair cohort study, utilizing data from clinical records, 3D gait analysis (3DGA), and structured telephone interviews.

Detailed Description

Not available

Study Timeline

• Study Start: 2024-01-01
• Status Verified: 2025-03
• Primary Completion: 2025-03-01
• Study Completion: 2025-03-01
• Study First Submitted: 2025-03-07
• Study First Submitted QC: 2025-03-12
• Study First Posted: 2025-03-25
• Last Update Submitted: 2025-03-28
• Last Update Posted: 2025-03-30

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

• Ambulatory children with spastic cerebral palsy (unilateral or bilateral).
• Indication for Achilles tendon lengthening confirmed by 3D gait analysis.
• Underwent unilateral either percutaneous needle technique or open Z-lengthening between 2015 and 2022.
• Availability of preoperative and one-year postoperative 3D gait analysis data.
• Informed consent obtained.

Exclusion Criteria

• Multilevel surgical interventions.
• Previous foot surgeries that alter foot anatomy.
• Non-compliance with rehabilitation protocols or orthotic use.
• Botulinum toxin-A injections in the triceps surae within six months pre- or post-surgery.
• Incomplete or inadequate 3D gait analysis data.
• Lack of informed consent.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Passive Ankle Dorsiflexion (Degrees)	Measured with the knee extended at one year postoperatively.	Passive Ankle Dorsiflexion (Degrees) measured with the knee flexed.

Secondary Outcome Measures

Name	Time	Method
Propulsive Power in Terminal Stance	Measured with the knee extended at one year postoperatively.	Propulsive Power in Terminal Stance: Measured in watts per kilogram using kinetic analysis.
Active Ankle Dorsiflexion (Degrees)	Measured with the knee extended at one year postoperatively.	Active Ankle Dorsiflexion (Degrees): Measured with the knee extended and flexed.
Maximum Ankle Dorsiflexion in Stance Phase	Measured with the knee extended at one year postoperatively.	Maximum Ankle Dorsiflexion in Stance Phase: Kinematic analysis during 3D gait analysis.
Postoperative Complications	Measured with the knee extended at one year postoperatively.	Postoperative Complications: Incidence of infections, hematoma, and re-ruptures within the first postoperative year.

Trial Locations

Locations (1)

Vestreviken; 🇳🇴 Drammen, Buskerud, Norway