How does patellar tendon advancement alter the knee extensor mechanism in children treated for crouch gait?

This was a retrospective study with no untreated or different-surgery control group. It came from one institution, so results may not match other centers. Only one postoperative follow-up was used, averaging 16 months, so longer-term changes are unknown. Over two-thirds of identified subjects were excluded because radiographs were missing, which may bias the sample. Previous or concurrent surgeries were allowed, so the effect of patellar tendon advancement cannot be separated from distal femoral extension osteotomy or other procedures. The improved outcome definition counted hyperextension as good, even though that is not an ideal result. The model used normative bone geometry and did not account for cerebral palsy bone shape changes. Moment arms were measured on planar radiographs, which were not always purely sagittal.

No conflict-of-interest declaration appears in the supplied text. The publication types list NIH extramural research support.

Do not conclude that patellar tendon advancement alone reduced crouch. All included knees were treated with distal femoral extension osteotomy plus patellar tendon advancement, and previous or concurrent surgeries were not excluded, so the contribution of any single component cannot be separated.