THE ADDED VALUE OF GAIT ANALYSIS IN CLUBFOOT RELAPSE

Introduction The diagnosis and treatment plan for relapsed clubfoot are based on clinical findings. Since 2019, gait analysis has been incorporated into the diagnostic evaluation of clubfoot relapse in our hospital. This study aims to explore the added value of gait analysis. Method In this retrospective study, patients with clubfeet relapse, initially treated with the Ponseti method, were included. A gait analysis using a KU Leuven foot model was performed. The diagnosis and treatment plan made by the pediatric orthopedic surgeon were compared to those outlined in the gait analysis report. Results Sixteen patients were included: 12 males (75%), with 7 unilateral (44%) and 13 idiopathic clubfeet (81%). The median age at relapse was 5 years (IQR 3-5 years). The gait analysis reported additional aspects of relapse for every child. Early heel rise was noted in 14 cases (88%), dynamic supination in 11 cases (69%), and midfoot break in 3 cases (19%). Non-surgical treatment recommendations varied between the pediatric orthopedic surgeon and the gait analysis report in all patients, gait analysis recommended inlays more frequently. In 14 patients (88%), the surgical plan differed. Gait analysis suggested Achilles tendon lengthening in five patients, tibialis anterior tendon transfer in four cases, and advised against tibialis anterior tendon transfer in three patients due to inadequate muscle strength. Conclusions Gait analysis provides added value by identifying subtle variations, potentially leading to modifications in the treatment plan. Further research is needed to determine whether these changes improve outcomes for patients with clubfoot relapse.