Cerebral Palsy Clinical Trial
Official title:
Controlling Femoral Derotation Osteotomy In Cerebral Palsy With Electromagnetic Tracking - A Randomized Controlled Trial
The study is designed to evaluate the use of electromagnetic tracking in transversal plane femoral derotation osteotomies. The goal is to raise the precision of the surgical procedure in order to improve the outcome in short- and long term. All patients are examined with an instrumented 3D gait analysis pre- and one year postoperatively. The electromagnetic tracking system is evaluated against a base line CT or MRI scan serving as reference standard pre- and postoperatively.
Internal rotation gait is a common deformity in children, especially in those with spastic
diplegia. The treatment includes soft tissue and bony correction. Especially the bony
procedures e.g. femoral derotation osteotomies have proven to be effective both in short term
and long term evaluation. Nonetheless there is still a relevant number of patients that
suffer from over- or under-correction and recurrence over time. The reasons are diverse and
include false measurement of the derotation in OR.
The study now evaluates electromagnetic tracking for femoral derotation to improve these
results.
The patients are recruited from the outpatients department and included if they meet the
criteria.
A baseline rotational CT or MRI scan and a 3D gait analysis are performed preoperatively. The
patients are randomized into a electromagnetic tracking group or a classical goniometer
group. The derotation is measured with the EMT system or with a classic Moeltgen goniometer
in the OR. Goal is to achieve the planned amount of derotation more accurately.
The surgical procedure follows standard rules and does not need alterations because of the
study.
After the operation a second rotational CT or MRI scan is performed and the derotation
precisely evaluated by two raters and later compared to the results of the intraoperative
electromagnetic tracking system. One year postoperative a second 3D gait analysis is
performed to measure and compare the functional and dynamic outcome.
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