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Patellar Tendon Imbrication Is a Safe and Efficacious Technique to Shorten the Patellar Tendon in Patients With Patella Alta

BACKGROUND: Patella alta has been noted to be a risk factor for recurrent patellar instability. PURPOSE: We conducted a radiographic study to determine whether a patellar tendon imbrication technique normalizes patellar height as well as whether the shortened length is maintained at a minimum 2-year...

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Autores principales: Patel, Ronak M., Gombosh, Michael, Polster, Joshua, Andrish, Jack
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7605011/
https://www.ncbi.nlm.nih.gov/pubmed/33195712
http://dx.doi.org/10.1177/2325967120959318
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author Patel, Ronak M.
Gombosh, Michael
Polster, Joshua
Andrish, Jack
author_facet Patel, Ronak M.
Gombosh, Michael
Polster, Joshua
Andrish, Jack
author_sort Patel, Ronak M.
collection PubMed
description BACKGROUND: Patella alta has been noted to be a risk factor for recurrent patellar instability. PURPOSE: We conducted a radiographic study to determine whether a patellar tendon imbrication technique normalizes patellar height as well as whether the shortened length is maintained at a minimum 2-year follow-up. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A total of 54 consecutive patients were identified after a retrospective chart review was performed on patients who underwent patellar tendon imbrication between 2008 and 2013. Preoperative, 3 weeks postoperative, and minimum 2 years postoperative lateral radiographs were analyzed using Insall-Salvati (IS), Blackburne-Peel (BP), and Caton-Deschamps (CD) indices to determine the amount of shortening that was achieved after the procedure and to what degree that shortening was maintained at a minimum 2-year follow-up. RESULTS: A total of 27 patients (32 knees) completed a minimum 2-year follow-up. The mean patellar tendon length preoperatively was 6.1 cm (range, 5-8 cm). At 3 weeks and 2 years, the mean tendon lengths were 5.1 and 5.2 cm, respectively. Thus, the mean ± SD change in patellar tendon length from preoperative to 3 weeks postoperative was 0.97 ± 0.67 cm. IS, BP, and CD ratios had minimal change (loss of correction) from 3-week to 2-year follow-up; the delta values were 0.04, –0.03, and 0.09, respectively. There were no complications directly related to the technique. CONCLUSION: Patellar tendon imbrication is a safe and effective procedure to correct patella alta in the setting of lateral patellar instability. On average, the technique allowed 1 cm of patellar tendon shortening and maintained the correction at a minimum 2-year follow-up. In the skeletally immature patient, this technique allows correction of patella alta by avoidance of a tibial tuberosity osteotomy.
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spelling pubmed-76050112020-11-12 Patellar Tendon Imbrication Is a Safe and Efficacious Technique to Shorten the Patellar Tendon in Patients With Patella Alta Patel, Ronak M. Gombosh, Michael Polster, Joshua Andrish, Jack Orthop J Sports Med Article BACKGROUND: Patella alta has been noted to be a risk factor for recurrent patellar instability. PURPOSE: We conducted a radiographic study to determine whether a patellar tendon imbrication technique normalizes patellar height as well as whether the shortened length is maintained at a minimum 2-year follow-up. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A total of 54 consecutive patients were identified after a retrospective chart review was performed on patients who underwent patellar tendon imbrication between 2008 and 2013. Preoperative, 3 weeks postoperative, and minimum 2 years postoperative lateral radiographs were analyzed using Insall-Salvati (IS), Blackburne-Peel (BP), and Caton-Deschamps (CD) indices to determine the amount of shortening that was achieved after the procedure and to what degree that shortening was maintained at a minimum 2-year follow-up. RESULTS: A total of 27 patients (32 knees) completed a minimum 2-year follow-up. The mean patellar tendon length preoperatively was 6.1 cm (range, 5-8 cm). At 3 weeks and 2 years, the mean tendon lengths were 5.1 and 5.2 cm, respectively. Thus, the mean ± SD change in patellar tendon length from preoperative to 3 weeks postoperative was 0.97 ± 0.67 cm. IS, BP, and CD ratios had minimal change (loss of correction) from 3-week to 2-year follow-up; the delta values were 0.04, –0.03, and 0.09, respectively. There were no complications directly related to the technique. CONCLUSION: Patellar tendon imbrication is a safe and effective procedure to correct patella alta in the setting of lateral patellar instability. On average, the technique allowed 1 cm of patellar tendon shortening and maintained the correction at a minimum 2-year follow-up. In the skeletally immature patient, this technique allows correction of patella alta by avoidance of a tibial tuberosity osteotomy. SAGE Publications 2020-10-27 /pmc/articles/PMC7605011/ /pubmed/33195712 http://dx.doi.org/10.1177/2325967120959318 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Patel, Ronak M.
Gombosh, Michael
Polster, Joshua
Andrish, Jack
Patellar Tendon Imbrication Is a Safe and Efficacious Technique to Shorten the Patellar Tendon in Patients With Patella Alta
title Patellar Tendon Imbrication Is a Safe and Efficacious Technique to Shorten the Patellar Tendon in Patients With Patella Alta
title_full Patellar Tendon Imbrication Is a Safe and Efficacious Technique to Shorten the Patellar Tendon in Patients With Patella Alta
title_fullStr Patellar Tendon Imbrication Is a Safe and Efficacious Technique to Shorten the Patellar Tendon in Patients With Patella Alta
title_full_unstemmed Patellar Tendon Imbrication Is a Safe and Efficacious Technique to Shorten the Patellar Tendon in Patients With Patella Alta
title_short Patellar Tendon Imbrication Is a Safe and Efficacious Technique to Shorten the Patellar Tendon in Patients With Patella Alta
title_sort patellar tendon imbrication is a safe and efficacious technique to shorten the patellar tendon in patients with patella alta
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7605011/
https://www.ncbi.nlm.nih.gov/pubmed/33195712
http://dx.doi.org/10.1177/2325967120959318
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