Complications and Radiographic Outcomes of Tibial Tubercle Osteotomy at Minimum 5-Year Follow-up.

IF 2.4 3区医学 Q2 ORTHOPEDICS

Orthopaedic Journal of Sports Medicine Pub Date : 2024-10-10 eCollection Date: 2024-10-01 DOI:10.1177/23259671241278722

Sercan Yalcin, Karrington Seals, Peter Joo, John P Fulkerson, Lutul D Farrow

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引用次数: 0

Abstract

Background: Tibial tubercle osteotomy (TTO) is a commonly utilized surgery in the treatment of patellofemoral instability and chondrosis. A number of case series studies have reported on the mid- and long-term outcomes with varying complication rates.

Purpose: To report the incidence of major complications after TTO and the rate of progression of knee osteoarthritis at midterm follow-up.

Study design: Case series; Level of evidence, 4.

Methods: All patients who underwent primary TTO between January 1, 2010 and December 31, 2015, and who had ≥5 years of clinical follow-up data were included. Patient demographics and clinical and radiographic outcomes were recorded. Risk factors for complications were identified using multivariate logistic regression analysis.

Results: A total of 72 patients were included. The mean follow-up period was 104.8 months (range, 67-138 months). The overall complication rate was 38.9% (28/72 patients), and the incidence of major complications was 6.9%. Univariate logistic regression analysis revealed that patients with a history of smoking were more likely to experience a complication (odds ratio = 4.33 [95% CI, 1.29-14.53]; P = .02). Multivariate analysis with TTO as the main predictor indicated that complication rates were not affected by TTO procedure (TTO vs TTO+other), number of screws, or distalization. There was also no difference between anteromedialization and medialization TTO techniques. The rate of patients with Kellgren-Lawrence grade 3 to 4 increased from 12.0% preoperatively to 23.9% at the final follow-up. New osteophyte formation was detected in 5.8% of patients on anteroposterior radiographs and in 9.1% of patients on lateral radiographs.

Conclusion: In the current study, TTO was found to have a major complication rate of 6.9% at midterm follow-up. Smoking was a risk factor for major complications. Only 11.9% of patients had progression in tibiofemoral osteoarthritis at midterm follow-up.

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胫骨结节截骨术至少 5 年随访的并发症和放射学结果。

背景：胫骨结节截骨术（TTO）是治疗髌骨股骨不稳和软骨病的常用手术。目的：报告 TTO 术后主要并发症的发生率以及中期随访时膝关节骨性关节炎的进展率：研究设计：病例系列；证据级别：4：纳入2010年1月1日至2015年12月31日期间接受初次TTO且临床随访数据≥5年的所有患者。记录患者的人口统计学特征、临床和放射学结果。通过多变量逻辑回归分析确定了并发症的风险因素：结果：共纳入 72 名患者。平均随访时间为 104.8 个月（67-138 个月）。总并发症发生率为 38.9%（28/72 例患者），主要并发症发生率为 6.9%。单变量逻辑回归分析显示，有吸烟史的患者更容易出现并发症（几率比 = 4.33 [95% CI, 1.29-14.53]；P = .02）。以TTO为主要预测因素的多变量分析表明，并发症发生率不受TTO手术（TTO vs TTO+其他）、螺钉数量或远端化的影响。前内侧化和内侧化 TTO 技术之间也没有差异。Kellgren-Lawrence 3至4级患者的比例从术前的12.0%增加到最终随访时的23.9%。5.8%的患者在正位X光片上发现了新的骨质增生，9.1%的患者在侧位X光片上发现了新的骨质增生：本研究发现，在中期随访中，TTO 的主要并发症发生率为 6.9%。吸烟是主要并发症的一个风险因素。只有11.9%的患者在中期随访时胫股骨骨关节炎有所进展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Orthopaedic Journal of Sports Medicine Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

7.70%

发文量

876

审稿时长

12 weeks

期刊介绍： The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty. Topics include original research in the areas of: -Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries -Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot) -Relevant translational research -Sports traumatology/epidemiology -Knee and shoulder arthroplasty The OJSM also publishes relevant systematic reviews and meta-analyses. This journal is a member of the Committee on Publication Ethics (COPE).