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Of note, significantly increased anterior pelvic tilt was also observed. Conclusions Hamstring lengthening combined with a serial casting protocol was associated with significant postoperative improvements in a range of clinical (eg, knee contracture), functional (eg, pediatric outcomes data collection instrument Global), and kinematic (eg, knee extension in stance) parameters. Improvements following this minimally invasive surgery were comparable to outcomes from procedures with higher complication rates. Level of evidence This is a Leve