The iliopsoas and adductor tendons are often soft tissue barriers obstructing relocation of the femoral head into the acetabulum
and are frequently released to obtain reduction. We assessed whether posteromedial soft tissue release including sectioning
of the adductor longus and iliopsoas tendons would lead to alterations in joint angles and moments of the hip joint or other
major changes in the gait pattern. We conducted 3-D quantitative gait analysis of 10 patients (mean age, 8.1 years) who had
unilateral and surgically treated DDH before the age of 18 months. The mean single support time was shorter in the unaffected
side of the patients than in the healthy control group. Mean pelvic excursions in both frontal and sagittal planes and maximum
knee extension at stance of the affected and unaffected sides were higher in the patients than in the control group. Peak
hip flexion moment during swing phase was somewhat reduced, and the hip moment crossover point from extension to flexion was
slightly delayed in both the affected and unaffected sides. We could not identify an explanation for the slight deviations
due to limited data. However, sectioning of the adductor longus and iliopsoas tendons in DDH patients under 18 months old
did not appear to lead to major objective clinical gait alterations.
Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest,
patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved or waived approval for the human protocol for this investigation
and that all investigations were conducted in conformity with ethical principles of research.