1. Rectus femoris transfer 분당서울대학교병원 이승열

3. Rectus femoris muscle Origin –Anterior Inferior Iliac Spine and Ilium above toe acetabulum

4. Insertion –Quadriceps tendon to base of patella and onto tibial tuberosity via the patellar tendon Nerve to muscle –Femoral nerve (L2-L4)

5. Stiff knee gait

6. One of m/c gait abnormality in patients with spastic CP Typical finding –Decreased ROM of knee during swing phase Foot clearance problem Reduced gait velocity Reduced step length

7. Rectus femoris transfer Conventional treatment

8. Indication Positive Duncan-Ely sign

9. Gait analysis Decreased knee flexion in swing Decreased and delayed peak knee flexion in sweing

10. Dynamic electromyography –Pathological increased activity of the rectus femoris muscle

11. OP technique

17. Outcome

18. Keep the rectus as a hip flexor Convert the rectus into a knee flexor??? Elimination of the rectus femoris activity

19. Study plan Patients –321 pts Factors affecting the results of RFT –Age –Gender –Anatomical type –Functional scale (GMFCS level) –SEMLS concomitant with RFT

20. Long term results –LMM? Gait analysis (knee sagittal motion) GDI

21. MRI study 진행상황

22. SNUBH 근력측정 기기

24. Isokinetic muscle strength Isometric muscle strength

25. Hip –Flexion/extension –Adduction/abduction Knee –Flexion/extension Ankle –Dorsiflexion/plantarflexion –Inversion/eversion

26. Thank you!!