Clinical Improvement Is Achieved Following Tibial Tubercle Distomedialization for Patellar Maltracking and Patella Alta Without Instability
| Autor: | Tarik Bayoumi, Michel H.J. Stavenuiter, Dennis C. van Duijvenbode, Jelle P. van der List, Joyce L. Benner, Kirsten D.S. Boerma-Argelo |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
business.industry Visual analogue scale Rehabilitation Public Health Environmental and Occupational Health Physical Therapy Sports Therapy and Rehabilitation Osteoarthritis medicine.disease Surgery Conservative treatment medicine Original Article Orthopedics and Sports Medicine Patella Clinical significance business Case series Patellar maltracking Vas score |
| Zdroj: | Arthroscopy, Sports Medicine, and Rehabilitation |
| ISSN: | 2666-061X |
| DOI: | 10.1016/j.asmr.2021.01.027 |
| Popis: | Purpose To determine short-term patient-reported outcomes following distomedial tibial tubercle transfer (TTT) in patients with patellar maltracking and patella alta without instability. Methods A single-surgeon case series study was performed on patients receiving distomedial TTT for the indication of patellar maltracking and patella alta without instability, after nonresponse to conservative treatment. Patient-reported outcomes were assessed preoperatively and at 3-, 6-, 12-, and 24-month follow-up using Kujala, Knee injury and Osteoarthritis Outcome Score (KOOS), and visual analog scale (VAS) pain scores. Generalized estimating equations analyses were performed to study improvement over time. Minimal clinically important differences obtained from literature were used to determine clinical relevance. Results A total of 40 patients were included. Eight patients were lost to follow-up; thus, outcomes of 32 patients were analyzed. Mean follow-up was 22 months, median age was 21 years, and 75% were female. Mean Kujala score increased pre- to postoperatively from 55 ± 12 to 79 ± 16 (P < .001), KOOS from 48 ± 14 to 79 ± 15 (P < .001), and VAS from 64 ± 17 to 25 ± 21 (P < .001), respectively. Eighty-four percent had clinical improvement of Kujala score, 91% of KOOS, and 78% of VAS score. A plateau phase in pain reduction was reached at 3 months, and in functional improvement at 6 months follow-up, after which no further significant improvement was observed. Complication rate was 3% and removal of hardware rate was 72%. Conclusions: In this case series study, distomedial TTT led to clinically relevant functional improvement and pain reduction in patients with patellar maltracking and patella alta without instability. However, the removal of hardware rate was high (72%). Level of Evidence Level IV, therapeutic case series. |
| Databáze: | OpenAIRE |
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