Listen folks, we’re talking about Anterior distal femoral hemiepiphysiodesis (ADFH), a fantastic surgical treatment for kids with cerebral palsy who have flexed knee gait and fixed knee flexion deformities. Now, there’s been talk about increased anterior pelvic tilt after surgeries like this, but nobody’s looked into it after ADFH. We thought, maybe, just maybe, this tilt would increase after ADFH, especially when combined with hamstring lengthening (HSL). And guess what? We were right!

We had 34 participants, all around 13 years old. We found that the mean pelvic tilt across the gait cycle did increase after ADFH by 4.4 degrees. But here’s the kicker, it only increased significantly in the group that also had HSL – a whopping 11.1 degrees!

Now, the minimum knee flexion decreased, which means an increase in knee extension, and there was an increase in maximum normalized dynamic hamstring lengths. The anterior pelvic tilt increased significantly in kids with higher levels of motor function impairment, but not in those with lower levels.

Here’s the bottom line: ADFH without HSL doesn’t result in increased anterior pelvic tilt. So, surgeons, if you’ve got a patient with cerebral palsy and flexed knee gait, who has long dynamically modeled hamstrings, and you want to maintain pelvic tilt, consider ADFH. It’s a great option. This is a Level III-retrospective comparative study, folks. Believe me, we’ve done our homework.