Purpose: Many surgical techniques for isolated gastrocnemius recession have been described. The purpose of the present study is to compare their therapeutic efficacy and intrinsic stability on a fresh cadaveric model of gastrocnemius tightness.
Methods: The cadaveric model was established by distracting the knee with spacers composed of low-temperature thermoplastic material, and was identified by the Silfverskiöld test. Procedures of gastrocnemius recession described by Barouk, Baumann and Strayer were performed. The lengthening distance and improvement of ankle dorsiflexion were measured.
Results: The mean ankle angle of the cadaveric models was -15.4° with the knee fully extended, and 8.4° with the knee flexed. The increased angle achieved by the Strayer procedure was significantly greater than that achieved by the Barouk procedure and the Baumann procedure with one cut (P < 0.05), but similar to that of the Baumann procedure with two cuts (P > 0.05). Compared with the intramuscular lengthening of the gastrocnemius (Baumann and Barouk procedures), the stability of the lengthening after the Strayer procedure was the lowest.
Conclusion: The three techniques of isolated gastrocnemius recession have different efficacy and stability in cadaver trials, depending on their own anatomical characteristics. Our study supplies an anatomical guide for the selection of a proper procedure.
Keywords: Biomechanical study; Cadaveric model; Gastrocnemius tightness; Surgical lengthening.