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Derotational distal femoral osteotomy corrects excessive femoral anteversion in patients with patellofemoral instability: A systematic review.
Ribeiro, Ricardo; Gomes, Eluana; Ferreira, Bárbara; Figueiredo, Inês; Valente, Cristina; Delgado, Diego; Sánchez, Mikel; Andrade, Renato; Espregueira-Mendes, João.
Afiliación
  • Ribeiro R; School of Medicine, Minho University, Braga, Portugal.
  • Gomes E; Clínica Espregueira-FIFA Medical Centre of Excellence, Porto, Portugal.
  • Ferreira B; School of Medicine, Minho University, Braga, Portugal.
  • Figueiredo I; School of Medicine, Minho University, Braga, Portugal.
  • Valente C; Clínica Espregueira-FIFA Medical Centre of Excellence, Porto, Portugal.
  • Delgado D; Dom Henrique Research Centre, Porto, Portugal.
  • Sánchez M; Advanced Biological Therapy Unit, Hospital Vithas Vitoria, Vitoria-Gasteiz, Spain.
  • Andrade R; Advanced Biological Therapy Unit, Hospital Vithas Vitoria, Vitoria-Gasteiz, Spain.
  • Espregueira-Mendes J; Arthroscopic Surgery Unit, Hospital Vithas Vitoria, Vitoria-Gasteiz, Spain.
Knee Surg Sports Traumatol Arthrosc ; 32(3): 713-724, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38385776
ABSTRACT

PURPOSE:

Patellofemoral 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.

METHODS:

Searches 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).

RESULTS:

Ten 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%).

CONCLUSIONS:

The 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 EVIDENCE Level IV, systematic review of level II-IV studies.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Osteotomía / Articulación Patelofemoral / Fémur / Inestabilidad de la Articulación Límite: Humans Idioma: En Revista: Knee Surg Sports Traumatol Arthrosc Asunto de la revista: MEDICINA ESPORTIVA / TRAUMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Portugal

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Osteotomía / Articulación Patelofemoral / Fémur / Inestabilidad de la Articulación Límite: Humans Idioma: En Revista: Knee Surg Sports Traumatol Arthrosc Asunto de la revista: MEDICINA ESPORTIVA / TRAUMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Portugal