Anterior distal femoral hemiepiphysiodesis for knee flexion contracture in paediatric patients with neuromuscular disorders: A systematic review and meta- analysis

Background: This meta-analysis assesses the effectiveness of ADFH in the operative management of knee flexion contracture in children with neuromuscular disorders. Methods: The study included 218 patients and assessed 340 knees. Patients had a median age of 11 years (age range 4-17 years) at initial evaluation. The mean follow up time was 25 months. Results: Gait deviation index improved by 8.49 points following ADFH (95 % CI 4.82-12.15, p < 0.01). Minimum flexion angle saw an overall improvement of 20.61 degrees (95 % CI 15.8-26.04, p < 0.001). Knee flexion contracture had an overall improvement of 11.74 degrees across (95 % CI 10.14-13.33, p < 0.001). Popliteal angle improved by 15.59 degrees overall following ADFH (95 % CI 7.57-23.60), p < 0.01). Conclusion: Orthopaedic operations are known to improve knee kinematics and clinical examination findings in neuromuscular disorder patients. ADFH is effective in improving passive and dynamic sagittal knee function.