Derotational distal femoral osteotomy corrects excessive femoral anteversion in patients with patellofemoral instability: A systematic review

被引:4
作者
Ribeiro, Ricardo [1 ]
Gomes, Eluana [2 ]
Ferreira, Barbara [1 ]
Figueiredo, Ines [1 ]
Valente, Cristina [2 ,3 ]
Delgado, Diego [4 ]
Sanchez, Mikel [4 ,5 ]
Andrade, Renato [2 ,3 ,6 ]
Espregueira-Mendes, Joao [1 ,2 ,3 ,7 ,8 ,9 ]
机构
[1] Minho Univ, Sch Med, Braga, Portugal
[2] Clin Espregueira FIFA Med Ctr Excellence, Porto, Portugal
[3] Dom Henrique Res Ctr, Porto, Portugal
[4] Hosp Vithas Vitoria, Adv Biol Therapy Unit, Vitoria, Spain
[5] Hosp Vithas Vitoria, Arthroscop Surg Unit, Vitoria, Spain
[6] Univ Porto, Fac Sport, Porto Biomech Lab LABIOMEP, Porto, Portugal
[7] ICVS 3Bs PT Govt Associate Lab, Braga Guimaraes, Portugal
[8] Univ Minho, Headquarters European Inst Excellence Tissue Engn, 3Bs Res Grp Biomat Biodegradables & Biomimet, Braga, Portugal
[9] Clin Espregueira Dragao Entrada Nascente, piso 3, P-4350415 Porto, Portugal
关键词
anterior knee pain; derotational; distal femoral; osteotomy; patellofemoral instability; RECURRENT PATELLAR INSTABILITY; CLINICALLY IMPORTANT DIFFERENCE; ACCEPTABLE SYMPTOMATIC STATE; LIGAMENT RECONSTRUCTION; TROCHLEAR DYSPLASIA; DISLOCATION; ROTATION; TORSION;
D O I
10.1002/ksa.12097
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
PurposePatellofemoral instability (PFI) is a common condition that can be caused from multiple factors, including lower limb rotational malalignments. Determining precise criteria for performing corrective torsional osteotomy can be a daunting task due to the lack of consensus on normal and excessive values and the limited evidence-based data in the postoperative results. The purpose was to assess the clinical, functional and imaging outcomes following derotational distal femoral osteotomy (DDFO) in patients with PFI and/or anterior knee pain (AKP) associated with lower limb rotational malalignments.MethodsSearches were conducted on PubMed, EMBASE and Web of Science databases up to October 2023. Studies reporting outcomes after DDFO in patients with PFI and/or AKP were eligible for the systematic review. The primary outcome was imaging metrics, especially femoral anteversion. Secondary outcomes included the patient-reported outcome measures (PROMs) (clinical and functional). Quantitative synthesis involved the use of weighted averages to calculate pre- to postoperative mean differences (MD) and compare them against the minimal clinically important difference (MCID).ResultsTen studies (309 knees) were included with a mean follow-up of 36.1 +/- 11.7 months. Imaging outcomes consistently indicated the correction of femoral anteversion (MD = -19.4 degrees, 95% confidence interval: -20.1 to -18.7) following DDFO. PROMs showed significant improvements in most studies, exceeding the MCID. Patient satisfaction with the DDFO was high (93.3%).ConclusionsThe DDFO was an effective treatment option for correcting excessive femoral anteversion in patients with PFI associated with clinically relevant functional and clinical improvement and a high satisfaction rate.Level of EvidenceLevel IV, systematic review of level II-IV studies
引用
收藏
页码:713 / 724
页数:12
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