{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:45:05Z","timestamp":1787755505309,"version":"build-2784847793"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 13-year-old adolescent boy with spastic diplegic cerebral palsy (CP) presented with crouch gait and bilateral knee flexion contractures (KFCs). After failure of conservative treatments, the patient was referred to orthopaedics for surgical intervention. Anterior distal femoral hemiepiphysiodesis (ADFH), using a retrograde approach, and Strayer gastrocnemius recession were performed bilaterally. No complications were reported during surgery\/follow-up. Full-active knee extension and improved gait were achieved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>KFC is prevalent in ambulatory patients with CP, reducing gait function. Retrograde ADFH is an effective surgical intervention to reduce KFC and improve gait, and offers simpler insertion\/removal than the traditional antegrade technique.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.24.00085","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T19:09:11Z","timestamp":1724958551000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Retrograde Insertion Approach for Anterior Distal Femoral Hemiepiphysiodesis Procedure"],"prefix":"10.2106","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4251-6430","authenticated-orcid":false,"given":"Kellen T.","family":"Krajewski","sequence":"first","affiliation":[{"name":"Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado"},{"name":"Musculoskeletal Research Center, Department of Orthopedics, Children\u2019s Hospital Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5196-0138","authenticated-orcid":false,"given":"Scott","family":"Miller","sequence":"additional","affiliation":[{"name":"Musculoskeletal Research Center, Department of Orthopedics, Children\u2019s Hospital Colorado, Aurora, Colorado"},{"name":"Center for Gait and Movement Analysis (CGMA), Children\u2019s Hospital Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2760-6972","authenticated-orcid":false,"given":"Radomir","family":"Dimovski","sequence":"additional","affiliation":[{"name":"Musculoskeletal Research Center, Department of Orthopedics, Children\u2019s Hospital Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6124-8590","authenticated-orcid":false,"given":"Jason","family":"Rhodes","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado"},{"name":"Musculoskeletal Research Center, Department of Orthopedics, Children\u2019s Hospital Colorado, Aurora, Colorado"},{"name":"Center for Gait and Movement Analysis (CGMA), Children\u2019s Hospital Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7525-4724","authenticated-orcid":false,"given":"Sayan","family":"De","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado"},{"name":"Musculoskeletal Research Center, Department of Orthopedics, Children\u2019s Hospital Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,7]]},"reference":[{"issue":"4","key":"bib1-20240829","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/dmcn.13659","article-title":"Demographic and modifiable factors associated with knee contracture in children with cerebral palsy","volume":"60","author":"Cloodt","year":"2018","journal-title":"Dev Med Child Neurol."},{"issue":"1","key":"bib2-20240829","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1080\/09593985.2021.2007558","article-title":"Prevalence of knee contractures is high in children with cerebral palsy in Denmark","volume":"39","author":"Kleno","year":"2023","journal-title":"Physiother Theor Pract."},{"issue":"4","key":"bib3-20240829","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.ocl.2010.06.006","article-title":"Management of the knee in spastic diplegia: what is the dose?","volume":"41","author":"Young","year":"2010","journal-title":"Orthop Clin North Am."},{"issue":"9","key":"bib4-20240829","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1097\/BPO.0000000000001942","article-title":"Functional and clinical outcomes of combined simultaneous bilateral anterior distal femoral plate hemiepiphysiodesis and hamstrings release in management of knee flexion contractures in children with neuromuscular disorders","volume":"41","author":"Zaghloul","year":"2021","journal-title":"J Pediatr Orthop."},{"issue":"6","key":"bib5-20240829","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1097\/01241398-199311000-00001","article-title":"Late knee problems in myelomeningocele","volume":"13","author":"Williams","year":"1993","journal-title":"J Pediatr Orthop."},{"issue":"4","key":"bib6-20240829","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1097\/01.bpb.0000271313.72750.37","article-title":"Joint distraction and reconstruction in complex knee contractures","volume":"27","author":"Devalia","year":"2007","journal-title":"J Pediatr Orthop."},{"issue":"5","key":"bib7-20240829","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1097\/01.mph.0000165136.76238.23","article-title":"Crouched gait in myelomeningocele - 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