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good Outcomes of Combined Femoral Derotation Osteotomy and Medial Retinaculum Plasty in Patients with Recurrent Patellar Dislocation
OBJECTIVES: To report the clinical outcomes of combined femoral derotation osteotomy and medial retinaculum plasty for recurrent patellar dislocation in patients with excessive femoral anteversion. METHODS: From January 2015 to March 2018, 20 knees in 20 patients (18 female, 2 male) with a mean age...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons Australia, Ltd
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6712378/ https://www.ncbi.nlm.nih.gov/pubmed/31419069 http://dx.doi.org/10.1111/os.12500 |
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author | Yang, Guang‐min Wang, Yan‐yang Zuo, Li‐xiong Li, Fa‐quan Dai, Yi‐ke Wang, Fei |
author_facet | Yang, Guang‐min Wang, Yan‐yang Zuo, Li‐xiong Li, Fa‐quan Dai, Yi‐ke Wang, Fei |
author_sort | Yang, Guang‐min |
collection | PubMed |
description | OBJECTIVES: To report the clinical outcomes of combined femoral derotation osteotomy and medial retinaculum plasty for recurrent patellar dislocation in patients with excessive femoral anteversion. METHODS: From January 2015 to March 2018, 20 knees in 20 patients (18 female, 2 male) with a mean age of 21 ± 4.2 years (range, 16 to 28 years) were retrospectively reviewed. All patients had undergone femoral derotation osteotomy and medial retinaculum plasty for recurrent patellar dislocation and excessive femoral anteversion angle (FAA > 25°). CT and X‐rays were used to assess the correction of the femoral anteversion angle, the tibia tuberosity‐trochlear groove (TT‐TG) distance, patellar tilt, and the congruence angle following the combinatory operations. Subjective scores, such as Kujala, International Knee Documentation Committee (IKDC), Tegner, and visual analogue scale (VAS) scores, were used to evaluate knee function preoperatively and postoperatively. RESULTS: No recurrence of patellar dislocation occurred in these patients during an average of 18 months (range, 12 to 23 months) of follow‐up. The mean of the FAA was corrected to 15.80° ± 3.58° postoperatively compared with 31.42° ± 4.95° preoperatively (P < 0.001). The TT‐TG distance was decreased from 22.17 ± 5.28 mm before surgery to 19.42 ± 4.57 mm after surgery (P = 0.03). The patellar tilt and congruence angle were improved from 30.43° ± 5.30°, 43.30° ± 11.04° to 15.80° ± 3.94°, 16.64° ± 9.98°, respectively (P < 0.001). The Kujala score was improved from 72.4 ± 19.90 before the surgery to 88.2 ± 12.25 after the surgery (P < 0.001). The IKDC score was improved from 70.56 ± 21.44 to 90.78 ± 14.32, and the VAS score was decreased from 4.23 ± 2.11 preoperatively to 1.27 ± 1.08 postoperatively (P < 0.001). No significant difference in Tegner score (5.46 ± 2.49 vs 5.79 ± 1.44) was found before and after the surgery (P = 0.2). Patients younger than 20 years old had lower Kujala (83.46 ± 14.56 vs. 90.84 ± 7.74, P = 0.02) and IKDC (83.49 ± 17.35 vs 92.46 ± 9.28, P = 0.04) scores than those older than 20 years. CONCLUSION: Good knee function, pain relief, and improved patellofemoral congruence were achieved with the combined femoral derotation osteotomy and medial retinaculum plasty. The combined operations serve as an ideal treatment for recurrent patellar dislocation and address the primary risk factors. |
format | Online Article Text |
id | pubmed-6712378 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | John Wiley & Sons Australia, Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-67123782019-09-10 good Outcomes of Combined Femoral Derotation Osteotomy and Medial Retinaculum Plasty in Patients with Recurrent Patellar Dislocation Yang, Guang‐min Wang, Yan‐yang Zuo, Li‐xiong Li, Fa‐quan Dai, Yi‐ke Wang, Fei Orthop Surg Clinical Articles OBJECTIVES: To report the clinical outcomes of combined femoral derotation osteotomy and medial retinaculum plasty for recurrent patellar dislocation in patients with excessive femoral anteversion. METHODS: From January 2015 to March 2018, 20 knees in 20 patients (18 female, 2 male) with a mean age of 21 ± 4.2 years (range, 16 to 28 years) were retrospectively reviewed. All patients had undergone femoral derotation osteotomy and medial retinaculum plasty for recurrent patellar dislocation and excessive femoral anteversion angle (FAA > 25°). CT and X‐rays were used to assess the correction of the femoral anteversion angle, the tibia tuberosity‐trochlear groove (TT‐TG) distance, patellar tilt, and the congruence angle following the combinatory operations. Subjective scores, such as Kujala, International Knee Documentation Committee (IKDC), Tegner, and visual analogue scale (VAS) scores, were used to evaluate knee function preoperatively and postoperatively. RESULTS: No recurrence of patellar dislocation occurred in these patients during an average of 18 months (range, 12 to 23 months) of follow‐up. The mean of the FAA was corrected to 15.80° ± 3.58° postoperatively compared with 31.42° ± 4.95° preoperatively (P < 0.001). The TT‐TG distance was decreased from 22.17 ± 5.28 mm before surgery to 19.42 ± 4.57 mm after surgery (P = 0.03). The patellar tilt and congruence angle were improved from 30.43° ± 5.30°, 43.30° ± 11.04° to 15.80° ± 3.94°, 16.64° ± 9.98°, respectively (P < 0.001). The Kujala score was improved from 72.4 ± 19.90 before the surgery to 88.2 ± 12.25 after the surgery (P < 0.001). The IKDC score was improved from 70.56 ± 21.44 to 90.78 ± 14.32, and the VAS score was decreased from 4.23 ± 2.11 preoperatively to 1.27 ± 1.08 postoperatively (P < 0.001). No significant difference in Tegner score (5.46 ± 2.49 vs 5.79 ± 1.44) was found before and after the surgery (P = 0.2). Patients younger than 20 years old had lower Kujala (83.46 ± 14.56 vs. 90.84 ± 7.74, P = 0.02) and IKDC (83.49 ± 17.35 vs 92.46 ± 9.28, P = 0.04) scores than those older than 20 years. CONCLUSION: Good knee function, pain relief, and improved patellofemoral congruence were achieved with the combined femoral derotation osteotomy and medial retinaculum plasty. The combined operations serve as an ideal treatment for recurrent patellar dislocation and address the primary risk factors. John Wiley & Sons Australia, Ltd 2019-08-16 /pmc/articles/PMC6712378/ /pubmed/31419069 http://dx.doi.org/10.1111/os.12500 Text en © 2019 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Articles Yang, Guang‐min Wang, Yan‐yang Zuo, Li‐xiong Li, Fa‐quan Dai, Yi‐ke Wang, Fei good Outcomes of Combined Femoral Derotation Osteotomy and Medial Retinaculum Plasty in Patients with Recurrent Patellar Dislocation |
title |
good Outcomes of Combined Femoral Derotation Osteotomy and Medial Retinaculum Plasty in Patients with Recurrent Patellar Dislocation |
title_full |
good Outcomes of Combined Femoral Derotation Osteotomy and Medial Retinaculum Plasty in Patients with Recurrent Patellar Dislocation |
title_fullStr |
good Outcomes of Combined Femoral Derotation Osteotomy and Medial Retinaculum Plasty in Patients with Recurrent Patellar Dislocation |
title_full_unstemmed |
good Outcomes of Combined Femoral Derotation Osteotomy and Medial Retinaculum Plasty in Patients with Recurrent Patellar Dislocation |
title_short |
good Outcomes of Combined Femoral Derotation Osteotomy and Medial Retinaculum Plasty in Patients with Recurrent Patellar Dislocation |
title_sort | good outcomes of combined femoral derotation osteotomy and medial retinaculum plasty in patients with recurrent patellar dislocation |
topic | Clinical Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6712378/ https://www.ncbi.nlm.nih.gov/pubmed/31419069 http://dx.doi.org/10.1111/os.12500 |
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