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Lateral trochlear lengthening osteotomy

Ismailidis, Petros and Egloff, Christian and Nüesch, Corina and Mündermann, Annegret and Pagenstert, Geert. (2021) Lateral trochlear lengthening osteotomy. Archives of orthopaedic and trauma surgery, 141 (10). pp. 1721-1730.

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Abstract

The purpose of this study was to describe the indications and technical aspects as well as evaluate the clinical and functional outcome of lengthening osteotomy of the lateral trochlear ridge in patients with patellofemoral pain and/or patella instability and presence of trochlear dysplasia Dejour type A or lack of Dejour type dysplasia and short lateral articular trochlea.; Six consecutive adult patients were treated with a lateral trochlear lengthening osteotomy. Five patients received a concomitant medial patellofemoral ligament reconstruction. Three patients had prior patella stabilization surgeries. Trochlea dysplasia (Dejour classification), Caton-Dechamps index, tibial tubercle trochlear groove (TT-TG) distance, patellar tilt and lateral condylar index were measured in preoperative MRIs. Clinical and functional evaluation included the Kujala Anterior Knee Pain Scale, the Lysholm Knee Score, the Tegner Activity Score, a subjective evaluation form and isokinetic muscle strength.; Four patients had a Dejour type A dysplasia, two patients had no dysplasia. The mean (range) Caton-Dechamps index was 1.09 (0.95-1.16), TT-TG distance 10.9 mm (9.2-15.6 mm), patellar tilt 15° (4-32°) and lateral condylar index 82.0% (74-90%). One patient was lost to follow up, all others were followed for 2-5 years. All patients were satisfied with the clinical outcome. The Lysholm score increased from 55 (37-79) to 89 (76-100), the Tegner activity score from 3.6 (2-6) to 5.6 (5-7). The Kujala score postoperative was 90 (75-96). Some but not all patients had full strength recovery compared to the contralateral leg.; We recommend measuring the lateral condylar index and considering the indication of a lateral trochlear lengthening osteotomy as an additional or isolated procedure in selected patients with trochlear dysplasia Dejour type A or lack of dysplasia and short lateral articular trochlea depending on the extent of the patellar instability.; Level IV, Case Series.; NCT04378491, clinicaltrials.gov, May 7, 2020.
Faculties and Departments:03 Faculty of Medicine > Bereich Operative Fächer (Klinik) > Bewegungsapparat und Integument > Traumatologie / Orthopädie (Jakob)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Operative Fächer (Klinik) > Bewegungsapparat und Integument > Traumatologie / Orthopädie (Jakob)
03 Faculty of Medicine > Departement Biomedical Engineering > Biomechanics and Biomaterials
03 Faculty of Medicine > Departement Klinische Forschung
UniBasel Contributors:Ismailidis, Petros and Egloff, Christian and Nüesch, Corina and Pagenstert, Geert and Mündermann, Annegret
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Springer
ISSN:1434-3916
e-ISSN:1434-3916
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:22 Sep 2021 09:41
Deposited On:22 Sep 2021 09:41

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