E-viri
Recenzirano
Odprti dostop
-
Rouanet, T; Gougeon, F; Fayard, J.M; Rémy, F; Migaud, H; Pasquier, G
Orthopaedics & traumatology, surgery & research, 06/2015, Letnik: 101, Številka: 4Journal Article
Abstract Introduction Trochlear dysplasia is one of the main elements of patellofemoral instability. Although correction by trochleoplasty seems logical, the long-term outcome of this procedure is unknown and the progression to osteoarthritis has not been clarified. Thus, we performed a retrospective study of a series of sulcus deepening trochleoplasties with a 15-year follow-up whose goal was to (1) evaluate the long-term clinical outcome and radiological rate of osteoarthritis, and (2) define the results in relation to the type of instability and the grade of dysplasia. Hypothesis Sulcus deepening trochleoplasty is an effective procedure to stabilize the patellofemoral joint that does not increase the risk of osteoarthritis. Patients and methods This retrospective study analyzed 34 sulcus deepening trochleoplasties based on clinical scores (IKS, Lille, Kujala and Oxford scores) and radiological results (stage of osteoarthritis according to the Iwano score) after a mean follow-up of 15 years (12–19 years). An Insall procedure was systematically associated with an anterior tibial tubercle transfer in 17 cases (7 prior tibial transfers). Results No recurrent objective instability was observed. Seven knees had additional surgery after a mean follow-up of 7 years (2–16): 7 underwent conversion to total knee arthroplasty because of progression of osteoarthritis and one knee had tibial tubercle transfer for pain and episodes of the knee giving way. The mean Lille, Kujala and IKS scores increased from 53.3 (30–92), 55 (13–75) and 127 (54–184) to 61.5 (25–93), 76 (51–94) and 152.4 (66–200) respectively between preoperative and follow-up assessment ( P < 0.05) (revisions included). Functional outcome was significantly better for dysplasia with supratrochlear spurs (IKS score 168 127–200 versus 153 98–198 and Kujula score 81.5 51–98 versus 76 51–94 P < 0.05). Patients were satisfied in 65% of the cases and the total mean Oxford score was 24.1/60 (12–45 points). Occasional pain was present in 53% of the cases. The trochlear prominence decreased from 4.9 mm (3–9 mm) to −1.2 mm (−7–4 mm). Ten cases of preoperative patellofemoral osteoarthritis were identified, but none with > Iwano 2, while osteoarthritis was present in 33/34 cases at the final follow-up with 20 cases > Iwano 2 (65%). Discussion Sulcus deepening trochleoplasty corrects patellofemoral stability even in patients with severe dysplasia and the long-term functional outcome is better in this group. It does not prevent patellofemoral osteoarthritis. It should be limited to severe dysplasia with supratrochlear spurs and associated with procedures to realign the extensor apparatus. Level of evidence IV, retrospective cohort study.
![loading ... loading ...](themes/default/img/ajax-loading.gif)
Vnos na polico
Trajna povezava
- URL:
Faktor vpliva
Dostop do baze podatkov JCR je dovoljen samo uporabnikom iz Slovenije. Vaš trenutni IP-naslov ni na seznamu dovoljenih za dostop, zato je potrebna avtentikacija z ustreznim računom AAI.
Leto | Faktor vpliva | Izdaja | Kategorija | Razvrstitev | ||||
---|---|---|---|---|---|---|---|---|
JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
Baze podatkov, v katerih je revija indeksirana
Ime baze podatkov | Področje | Leto |
---|
Povezave do osebnih bibliografij avtorjev | Povezave do podatkov o raziskovalcih v sistemu SICRIS |
---|
Vir: Osebne bibliografije
in: SICRIS
To gradivo vam je dostopno v celotnem besedilu. Če kljub temu želite naročiti gradivo, kliknite gumb Nadaljuj.