Varus osteotomy as a salvage procedure for young patients with symptomatic patellofemoral arthritis and valgus malalignment at short- to mid-term follow-up: a case series

Maximilian Hinz, Maximilian Weyer, Moritz Brunner, Lorenz Fritsch,Alexander Otto, Sebastian Siebenlist,Andrea Achtnich

ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY(2024)

引用 0|浏览4
暂无评分
摘要
Purpose The purpose of the study was to report the clinical, functional and radiological outcome following varus osteotomy as a salvage procedure in young to middle-aged patients with patellofemoral arthritis (PFA) and associated valgus malalignment. It was hypothesized that a significant improvement in knee function and reduction in pain would be achieved. Moreover, no conversion to patellofemoral joint arthroplasty could be observed. Material and methods Patients (< 50 years of age) that underwent varus osteotomy between 08/2012 and 01/2020 for the treatment of symptomatic PFA and associated valgus malalignment were consecutively included (minimum follow-up: 24 months). Patient-reported outcome measures (PROM; International Knee Documentation Committee subjective knee form [IKDC]), Visual Analog Scale [VAS] for pain, Tegner Activity Scale [TAS], and satisfaction with the postoperative results (1- 10-scale, 10 = highest satisfaction) and weight-bearing whole-leg anteroposterior radiographs were conducted pre- and postoperatively. The change in PROM and femorotibial angle (FTA) were tested for statistical significance. Results In total, 12 patients (14 knees) were included (66.7% female; mean age: 33.8 +/- SD 6.6 years). In ten cases, lateral opening-wedge distal femoral osteotomies (DFO) were performed, of which three cases included a concomitant femoral derotation. Three medial closing-wedge DFO and one medial closing-wedge high tibial osteotomy were performed. At follow-up (55.3 +/- 29.3 months), a significant improvement in knee function (IKDC: 56.4 +/- 14.4 to 69.1 +/- 11.2, p = 0.015) and reduction in pain (VAS for pain: 3.5 [interquartile range 2.3-5.8] to 0.5 [0-2.0], p = 0.018) were observed. Patients were able to reach their preoperative sporting activity level (TAS: 3.0 [3.0-4.0] to 3.5 [3.0-4.0], p = 0.854) and were highly satisfied with the postoperative result (9.0 [6.5-10]). Additionally, a significant correction of valgus malalignment was observed (5.0 degrees +/- 2.9 degrees valgus to 0.7 degrees +/- 3.2 degrees varus, p < 0.001). Regarding complications, two re-osteosyntheses were performed due to loss of correction and delayed union. No conversion to patellofemoral arthroplasty occurred. Conclusion In patients with symptomatic PFA and associated valgus malalignment, varus osteotomy as a salvage procedure achieved a significant improvement in knee function and reduction in pain. No conversion to patellofemoral joint arthroplasty occurred at short- to mid-term follow-up. Level of evidence Retrospective case series, Level IV.
更多
查看译文
关键词
Patellofemoral joint,Patellofemoral osteoarthritis,Joint preservation,Maltracking
AI 理解论文
溯源树
样例
生成溯源树,研究论文发展脉络
Chat Paper
正在生成论文摘要