A modified Delphi consensus statement on patellar instability: part II.

Autor:	Hurley ET; Department of Orthopedic Surgery, New York University Langone Health, New York, USA.; Department of Orthopaedic Surgery, Duke University Hospital, Durham, North Carolina, USA., Sherman SL; Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA., Chahla J; Ankara Yildirim Beyazit University, Ankara, Turkey., Gursoy S; Ankara Yildirim Beyazit University, Ankara, Turkey., Alaia MJ; Department of Orthopedic Surgery, New York University Langone Health, New York, USA., Tanaka MJ; Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA., Pace JL; Children's Health Andrews Institute for Orthopaedics and Sports Medicine, Plano, Texas, USA., Jazrawi LM; Department of Orthopedic Surgery, New York University Langone Health, New York, USA., Hughes AJ; Department of Orthopedic Surgery, NYU Langone Health, New York, New York, USA., Arendt EA; Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA., Ayeni OR; Division of Orthopaedic Surgery, McMaster University, Hamilton, Canada., Bassett AJ; The Orthopedic Institute of New Jersey, Morristown, New Jersey, USA., Bonner KF; Jordan-Young Institute, Virginia Beach, Virginia, USA., Camp CL; Department of Orthopaedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota, USA., Campbell KA; Department of Orthopedic Surgery, NYU Langone Health, New York, New York, USA., Carter CW; Department of Orthopedic Surgery, NYU Langone Health, New York, New York, USA., Ciccotti MG; Rothman Orthopaedic Institute at Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA., Cosgarea AJ; Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland, USA., Dejour D; Lyon-Ortho-Clinic, Clinique de La Sauvegarde, Lyon, France., Edgar CM; Department of Orthopedics, University of Connecticut Health Center, Farmington, Connecticut, USA., Erickson BJ; Rothman Orthopaedic Institute, New York, USA., Espregueira-Mendes J; Dom Research Center, Clinica Espregueira Mendes, FIFA Medical Centre of Excellence, Porto, Portugal., Farr J; OrthoIndy Knee Preservation and Cartilage Restoration Center, Indianapolis, Indiana, USA., Farrow LD; Cleveland Clinic Orthopaedic and Rheumatologic Institute, Cleveland, Ohio, USA., Frank RM; Department of Orthopaedic Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA., Freedman KB; Rothman Orthopaedic Institute at Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA., Fulkerson JP; Department of Orthopaedic Surgery and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut, USA., Getgood A; Fowler Kennedy Sports Medicine Clinic, Western University, London, Canada., Gomoll AH; Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, USA., Grant JA; Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA., Gwathmey FW; Department of Orthopaedic Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA., Haddad FS; Department of Trauma and Orthopaedic Surgery, University College London Hospitals, London, UK., Hiemstra LA; Department of Surgery, University of Calgary, Calgary, Canada., Hinckel BB; Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak, Michigan, USA., Savage-Elliott I; Department of Orthopedic Surgery, NYU Langone Health, New York, New York, USA., Koh JL; NorthShore Orthopaedic Institute, NorthShore University Health System, Evanston, Illinois, USA., Krych AJ; Department of Orthopaedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota, USA., LaPrade RF; Twin Cities Orthopedics, Edina-Crosstown, Edina, Minnesota, USA., Li ZI; Department of Orthopedic Surgery, NYU Langone Health, New York, New York, USA., Logan CA; Center for Regenerative Sports Medicine, Steadman Philippon Research Institute, Vail, Colorado, USA., Gonzalez-Lomas G; Department of Orthopedic Surgery, NYU Langone Health, New York, New York, USA., Mannino BJ; Department of Orthopedic Surgery, NYU Langone Health, New York, New York, USA., Lind M; Department of Sports Traumatology, Aarhus University Hospital, Aarhus, Denmark., Matache BA; Division of Orthopaedic Surgery, Department of Surgery, Laval University, Quebec, Canada., Matzkin E; Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA., Mandelbaum B; Cedars-Sinai Kerlan-Jobe Institute, Los Angeles, California, USA., McCarthy TF; Stryker Orthopaedics, Mahwah, New Jersey, USA., Mulcahey M; Department of Orthopaedic Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA., Musahl V; Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA., Neyret P; Department of Orthopaedic Surgery, Centre Albert-Trillat, Hôpital de La Croix-Rousse, Lyon, France., Nuelle CW; Department of Orthopedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri, USA., Oussedik S; University College London Hospitals NHS Foundation Trust, London, UK., Verdonk P; Antwerp Orthopaedic Center, AZ Monica Hospitals, Antwerp, Belgium., Rodeo SA; Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, USA., Rowan FE; Department of Trauma & Orthopaedic Surgery, University Hospital Waterford, Waterford, Ireland., Salzler MJ; Department of Orthopedics, Tufts University School of Medicine, Boston, Massachusetts, USA., Schottel PC; Department of Orthopaedics and Rehabilitation, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA., Shannon FJ; Department of Trauma and Orthopaedics, Galway University Hospitals, Galway, Ireland., Sheean AJ; San Antonio Military Medical Center, San Antonio, Texas, USA., Strickland SM; Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, USA., Waterman BR; Department of Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA., Wittstein JR; Department of Orthopaedic Surgery, Duke University Hospital, Durham, North Carolina, USA., Zacchilli M; Hofstra Northwell School of Medicine, Hempstead, New York, USA., Zaffagnini S; IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Jazyk:	angličtina
Zdroj:	The bone & joint journal [Bone Joint J] 2023 Dec 01; Vol. 105-B (12), pp. 1265-1270. Date of Electronic Publication: 2023 Dec 01.
DOI:	10.1302/0301-620X.105B12.BJJ-2023-0110.R1
Abstrakt:	Aims: The aim of this study was to establish consensus statements on medial patellofemoral ligament (MPFL) reconstruction, anteromedialization tibial tubercle osteotomy, trochleoplasty, and rehabilitation and return to sporting activity in patients with patellar instability, using the modified Delphi process. Methods: This was the second part of a study dealing with these aspects of management in these patients. As in part I, a total of 60 surgeons from 11 countries contributed to the development of consensus statements based on their expertise in this area. They were assigned to one of seven working groups defined by subtopics of interest. Consensus was defined as achieving between 80% and 89% agreement, strong consensus was defined as between 90% and 99% agreement, and 100% agreement was considered unanimous. Results: Of 41 questions and statements on patellar instability, none achieved unanimous consensus, 19 achieved strong consensus, 15 achieved consensus, and seven did not achieve consensus. Conclusion: Most statements reached some degree of consensus, without any achieving unanimous consensus. There was no consensus on the use of anchors in MPFL reconstruction, and the order of fixation of the graft (patella first versus femur first). There was also no consensus on the indications for trochleoplasty or its effect on the viability of the cartilage after elevation of the osteochondral flap. There was also no consensus on postoperative immobilization or weightbearing, or whether paediatric patients should avoid an early return to sport. Competing Interests: S. L. Sherman reports royalties or licenses from CONMED Linvatec, consulting fees from Arthrex, BioVentus, JRF Ortho, Kinamed, Smith & Nephew, Vericel, CONMED Linvatec, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Arthex, Joint Restoration Foundation, Kinamed, Smith & Nephew, and Vericel, and stock or stock options from Epic Bio, Reparel, Sarcio, and Vivorte, all of which are unrelated to this study. J. Chahla reports consulting fees from Arthrex, CONMED Linvatec, Ossur, and Smith & Nephew, and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Smith & Nephew, all of which are unrelated to this study. M. J. Alaia reports consulting fees from BodyCad, JRF Ortho, and Mitek, institutional grants from Orcosa, and royalties from Springer, all of which are unrelated to this study. M. J. Tanaka reports grants or contracts from FujiFilm, royalties or licenses from Verywell, and consulting fees from Depuy Synthes, all of which are unrelated to this study. J. L. Pace reports consulting fees from Arthrex and JRF Ortho, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Arthrex, and stock or stock options from OutcomeMD, all of which are unrelated to this study. L. M. Jazwari reports grants or contracts from Arthrex, Mitek, Smith & Nephew, and Wolters Kluwer Health, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Wolters Kluwer Health, and stock or stock options from Lazurite, all of which are unrelated to this study. (© 2023 The British Editorial Society of Bone & Joint Surgery.)
Databáze:	MEDLINE
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