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Tibial Derotational Osteotomy for Patellofemoral Instability: A Systematic Review

INTRODUCTION: The etiology of patellofemoral (PF) instability is multifactorial. Excessive external tibial torsion has been associated with recurrent patellar subluxation and persistent anterior knee pain. Several surgical techniques have been historically used to correct this, including medial pate...

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Autores principales: Wyatt, Phillip, Satalich, James, Gorica, Zylyftar, O'Neill, Conor, Cyrus, John, Vap, Alexander, O'Connell, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812606/
https://www.ncbi.nlm.nih.gov/pubmed/36620474
http://dx.doi.org/10.1155/2022/8672113
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author Wyatt, Phillip
Satalich, James
Gorica, Zylyftar
O'Neill, Conor
Cyrus, John
Vap, Alexander
O'Connell, Robert
author_facet Wyatt, Phillip
Satalich, James
Gorica, Zylyftar
O'Neill, Conor
Cyrus, John
Vap, Alexander
O'Connell, Robert
author_sort Wyatt, Phillip
collection PubMed
description INTRODUCTION: The etiology of patellofemoral (PF) instability is multifactorial. Excessive external tibial torsion has been associated with recurrent patellar subluxation and persistent anterior knee pain. Several surgical techniques have been historically used to correct this, including medial patellofemoral ligament reconstruction, tibial tuberosity transfer (TTT), trochleoplasty, and tibial derotation osteotomy (TDO). The purpose of this systematic review is to investigate the safety and efficacy of TDO for PF instability and pain. METHODS: A thorough search of the literature was conducted on July 15, 2022. Seven studies met the inclusion criteria for this systematic review. RESULTS: Among the included studies, there were 179 total subjects and 204 operative knees. Mean follow-up time was 66.31 months (range 11–192). Complication rate was low (12.8%) in studies that reported complications. Average degree of anatomical correction in the transverse plane was 19.9 degrees with TDO. This increased to 34 degrees when combined with TTT. All PROMs assessed were significantly increased postoperatively (p < 0.05). Age greater than 25 years and advanced PF chondromalacia may negatively affect postoperative outcomes. CONCLUSION: The primary findings of this review were as follows: (1) TDO results in significantly improved pain and PROM ratings in patients with PF pain and/or instability, (2) the likelihood of complication, including recurrent patella subluxation after TDO, is low but may be increased by aging, and (3) the successful anatomical correction of TDO may be augmented by concurrent TTT in some cases.
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spelling pubmed-98126062023-01-05 Tibial Derotational Osteotomy for Patellofemoral Instability: A Systematic Review Wyatt, Phillip Satalich, James Gorica, Zylyftar O'Neill, Conor Cyrus, John Vap, Alexander O'Connell, Robert Adv Orthop Research Article INTRODUCTION: The etiology of patellofemoral (PF) instability is multifactorial. Excessive external tibial torsion has been associated with recurrent patellar subluxation and persistent anterior knee pain. Several surgical techniques have been historically used to correct this, including medial patellofemoral ligament reconstruction, tibial tuberosity transfer (TTT), trochleoplasty, and tibial derotation osteotomy (TDO). The purpose of this systematic review is to investigate the safety and efficacy of TDO for PF instability and pain. METHODS: A thorough search of the literature was conducted on July 15, 2022. Seven studies met the inclusion criteria for this systematic review. RESULTS: Among the included studies, there were 179 total subjects and 204 operative knees. Mean follow-up time was 66.31 months (range 11–192). Complication rate was low (12.8%) in studies that reported complications. Average degree of anatomical correction in the transverse plane was 19.9 degrees with TDO. This increased to 34 degrees when combined with TTT. All PROMs assessed were significantly increased postoperatively (p < 0.05). Age greater than 25 years and advanced PF chondromalacia may negatively affect postoperative outcomes. CONCLUSION: The primary findings of this review were as follows: (1) TDO results in significantly improved pain and PROM ratings in patients with PF pain and/or instability, (2) the likelihood of complication, including recurrent patella subluxation after TDO, is low but may be increased by aging, and (3) the successful anatomical correction of TDO may be augmented by concurrent TTT in some cases. Hindawi 2022-12-28 /pmc/articles/PMC9812606/ /pubmed/36620474 http://dx.doi.org/10.1155/2022/8672113 Text en Copyright © 2022 Phillip Wyatt et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Wyatt, Phillip
Satalich, James
Gorica, Zylyftar
O'Neill, Conor
Cyrus, John
Vap, Alexander
O'Connell, Robert
Tibial Derotational Osteotomy for Patellofemoral Instability: A Systematic Review
title Tibial Derotational Osteotomy for Patellofemoral Instability: A Systematic Review
title_full Tibial Derotational Osteotomy for Patellofemoral Instability: A Systematic Review
title_fullStr Tibial Derotational Osteotomy for Patellofemoral Instability: A Systematic Review
title_full_unstemmed Tibial Derotational Osteotomy for Patellofemoral Instability: A Systematic Review
title_short Tibial Derotational Osteotomy for Patellofemoral Instability: A Systematic Review
title_sort tibial derotational osteotomy for patellofemoral instability: a systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812606/
https://www.ncbi.nlm.nih.gov/pubmed/36620474
http://dx.doi.org/10.1155/2022/8672113
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