Journal of Knee Surgery最新文献

{"title":"Patellar Overstuffing in Total Knee Arthroplasty Results in Decreased Extensor Mechanism Efficiency.","authors":"Brandon R Bukowski, Sonia K Chandi, Pravjit Bhatti, Paola Jimenez, Nathan Lenz, Fred D Cushner, Steven B Haas, Brian P Chalmers","doi":"10.1055/a-2514-9655","DOIUrl":"https://doi.org/10.1055/a-2514-9655","url":null,"abstract":"<p><p>Patellofemoral offset is influenced by patellar thickness in total knee arthroplasty (TKA), with effects on extensor mechanism efficiency (EME), patellar contact moment arm (PCMA), and patellar contact force (PCF). This study utilized a computational model to better quantify these measures during knee range of motion (ROM).A computational model of a cruciate-sacrificing, posterior-stabilized TKA design was used to quantify moments at knee flexion angles from 0° to 135° when patella thickness was increased (\"overstuffed\") or decreased (\"understuffed\") by 2 mm and 5 mm from normal. Outcomes included changes in EME, PCMA, PCF, tibial tubercle moment arm (TTMA), and the quadriceps moment arm (QMA).Overstuffing of the patellofemoral articulation by 2 mm and 5 mm decreased EME up to 12 and 28%, respectively, with an 8% and 16% increase in EME with understuffing that peaked at 25° knee flexion. The QMA increased up to 5 and 12% with overstuffing by 2 mm and 5 mm and decreased up to 5% and 14% with understuffing, respectively. There was an increase in the PCMA/PCF, which opposed the QMA, up to 8%/17% and 16%/39% with overstuffing by 2 mm and 5 mm, respectively. The PCMA/PCF decreased up to 3%/12% and 8%/33% with understuffing by 2 mm and 5 mm, respectively.In this computational model, increased patellofemoral offset resulting in overstuffing of the patella resulted in decreased EME and increased PCMA and PCF during knee ROM. This may contribute to abnormal patellofemoral mechanics and a potential etiology for anterior knee pain and quadriceps weakness after TKA.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation at Home with Interactive Technology.","authors":"Adam M Gordon, Rajan Sharma, Michael A Mont","doi":"10.1055/a-2534-1546","DOIUrl":"https://doi.org/10.1055/a-2534-1546","url":null,"abstract":"<p><strong>Introduction: </strong>Smartphone applications and wearable devices have shown promising outcomes to augment in-person postoperative total knee arthroplasty rehabilitation. Advantages of these technologies include patient-specific, real-time feedback and motivation which can be integrated into newer rehabilitation protocols. These technologies can be utilized in the home setting with patient directed therapy.</p><p><strong>Methods: </strong>This brief narrative review discusses the current utilization of smartphone applications and sensors for the postoperative rehabilitation period following total knee arthroplasty. This review will discuss how they are utilized for home-based rehabilitation and the outcomes of patients who utilize them. This review specifically focuses on recovery outcomes such as adherence/satisfaction, functional improvement, and gait patterns. Outcomes are primarily descriptive, with P values noted where appropriate.</p><p><strong>Results: </strong>This review highlights the growing evidence supporting the use of smartphone applications and wearable sensors as valuable tools in the rehabilitation process following total knee arthroplasty. Both technologies have been shown to enhance patient adherence, improve functional outcomes, mitigate pain, and provide valuable data for healthcare providers and patients. Importantly, the integration of these technologies, such as the combination of smartphone apps with wearable devices, can help improve patient outcomes when utilized in a home-based rehabilitation setting.</p><p><strong>Conclusions: </strong>Smartphone applications and wearable devices offer enhancements in postoperative rehabilitation following total knee arthroplasty. Despite being in their infancy, randomized trials have validated their effectiveness and utility in this context. Improved adherence to postoperative care plans emerged as recurrent findings.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Resurfaced Patellar Thickness on Outcomes after Total Knee Arthroplasty: Paper for Salman and Karen to process.","authors":"Siddhartha Dandamudi, Viktor Tollemar, Jonathan Spaan, Ashwinee Manivannan, Brett R Levine","doi":"10.1055/a-2530-7953","DOIUrl":"https://doi.org/10.1055/a-2530-7953","url":null,"abstract":"<p><p>Total knee arthroplasty (TKA) is the gold standard for treatment of end stage knee osteoarthritis. Patellar resurfacing is an optional step in the procedure and remains a controversial topic of discussion. This retrospective study aims to assess the impact of over-resecting and under-resecting the patella during resurfacing on patient reported outcomes (PROMs) and range of motion (ROM) after surgery. 438 (92.2%) of 475 patients who underwent TKA between August 2017 and November 2019 at a single center by a single surgeon were included in the analysis. Patients were split into three study groups based on reconstructed patellar thickness; normal resection (NR) was defined as within 2 mm native thickness, over-resected (OR) was defined as ≤ -2 mm, and under-resected (UR) was defined as ≥ 2 mm. Statistical analyses included chi-squared test, mixed effect models, and cox proportional hazards models. There were 364, 41, 33 patients were in NR, OR, UR group respectively. The cohort mean age at time of surgery was 67.1 ± 9.1 and had mean length of follow-up of 2.1 ± 1.7 years with no difference among cohorts. Significant differences were found in gender (p<0.001) and BMI (p=0.0134) with UR having less males, OR having more males, and OR having lower BMI. At 6 months, the complete cohort ROM improved from 108.7 ± 14.4 degrees to 111 ± 11 degrees, objective Knee Society Score (KSS) increase from 15.4 ± 11.2 to 36.2 ± 12, functional KSS increase from 47.3 ± 18.9 to 65.6 ± 22.2, and knee injury and osteoarthritis outcome score increase from 46.1 ± 15 to 70.7 ± 15 with no significant differences among cohorts. There were no patellofemoral related complications. This study supports that while it is important to restore the anatomy in the anterior compartment of the knee, minor changes in patellar thickness from patellar resurfacing likely have minimal impact on outcomes for patients. Further studies with a larger sample size are necessary to further validate these findings.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Conversion of Unicompartmental Knee Arthroplasty to Total Knee Arthroplasty with Non-CT-Based Robotic Assistance: A Novel Surgical Technique and Case Series.","authors":"Hamza M Raja, Luke Wesemann, Michael A Charters, W Trevor North","doi":"10.1055/a-2421-5496","DOIUrl":"10.1055/a-2421-5496","url":null,"abstract":"<p><p>Robotic-assisted devices help provide precise component positioning in conversion of unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA). A few studies offer surgical techniques for computed tomography (CT) based robotic-assisted conversion of UKA to TKA; however, no studies to date detail this procedure utilizing a non-CT-based robotic-assisted device. This article introduces a novel technique employing a non-CT-based robotic-assisted device (ROSA Knee System, Zimmer Biomet, Warsaw, IN) for converting UKA to TKA with a focus on its efficacy in gap balancing. We present three patients (ages 46-66 years) who were evaluated for conversion of UKA to TKA for aseptic loosening, stress fracture, and progressive osteoarthritis. Each patient underwent robotic-assisted conversion to TKA. Postoperative assessments at 6 months revealed improved pain, function, and radiographic stability. Preoperative planning included biplanar long leg radiographs to determine the anatomic and mechanical axis of the leg. After arthrotomy with a standard medial parapatellar approach, infrared reflectors were pinned into the femur and tibia, followed by topographical mapping of the knee with the UKA in situ. The intraoperative software was utilized to evaluate flexion and extension balancing and plan bony resections. Then, the robotic arm guided placement of the femoral and tibial guide pins and the UKA components were removed. After bony resection of the distal femur and proximal tibia, the intraoperative software was used to reassess the extension gap, and plan posterior condylar resection to have the flexion gap match the extension gap. The use of a non-CT-based robotic-assisted device in conversion of UKA to TKA is a novel technique and a good option for surgeons familiar with robotic-assisted arthroplasty, resulting in excellent outcomes at 6 months.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"141-147"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Anterior Cruciate Ligament Tears in National Football League Players by Short, Normal, or Long Rest Weeks.","authors":"Ashwin R Garlapaty, Joshua A Scheiderer, Kylee Rucinski, Steven F DeFroda","doi":"10.1055/a-2428-0119","DOIUrl":"10.1055/a-2428-0119","url":null,"abstract":"<p><p>Anterior cruciate ligament (ACL) tears in National Football League (NFL) players are devastating injuries that take nearly a year to recover. Players that do return to sport have worse overall performance compared to pre-ACL tear. NFL players typically play regular season games on Sunday with the next game played on the following Sunday, allowing for 6 days between games. Deviation from the usual 6-day rest week has been proposed as a potential risk for ACL tear. The main objective of this study was to evaluate the risk of decreased rest or increased rest on ACL tear rates in NFL players. ACL injury data of NFL players from the 2012 to 2013 season and 2022 to 2023 season were gathered from publicly available sources. Player demographic data, position, age at time of injury, seasons played, injury mechanism, and playing surface type were recorded. Injuries were characterized as short, normal, or long week injuries. ACL tears that occurred during the preseason, postseason, or during week 1 were excluded. Descriptive statistics were calculated to report means, ranges, and percentages. Data were analyzed to determine statistically significant differences using Fisher's exact, chi-square, or one-way analysis of variance tests. A total of 524 ACL tears were recorded in NFL players during the study window. Note that 304 ACL tears were excluded and 220 fit inclusion criteria. Twenty-four ACL tears occurred during short weeks, 68 during long weeks, and 128 during normal weeks. Players were 1.8 times more likely to tear their ACL during a long week compared to a normal week (<i>p</i> < 0.001), and 1.5 times more likely to tear their ACL during a short week compared to a normal week (<i>p</i> = 0.02). The findings from this study suggest that deviation from the normal 7-day NFL week increases the risk of an ACL tear in NFL players when increasing or decreasing rest time. Further research exploring the impact of short and long rest times on player injury risk should be conducted to prevent season-ending injuries.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"148-153"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective Use of Modern Cementless Total Knee Arthroplasty is Not Associated with Increased Risk of Revision in Patients Aged 65 or Greater: An Analysis from the American Joint Replacement Registry.","authors":"Ryland Kagan, Christopher E Pelt, Harpal S Khanuja, Julius K Oni, Isabella Zaniletti, Ayushmita De, Vishal Hegde","doi":"10.1055/a-2332-5762","DOIUrl":"10.1055/a-2332-5762","url":null,"abstract":"<p><p>Modern highly porous surfaces have increased confidence and use of cementless total knee arthroplasty (TKA) in the United States. As cementless TKA use increases, there remains a paucity of literature regarding associated risk of revision in patients aged ≥65 years. We analyzed the American Joint Replacement Registry (AJRR) data from January 2012 to March 2020 identifying patients aged ≥65 years undergoing primary TKA with linked cases to supplemental centers for Medicare and Medicaid data. Patients with hybrid fixation, reverse hybrid fixation, missing component data, highly constrained implants, and stem extension/augmentation were excluded. We identified 442,745 cemented TKAs and 19,841 modern cementless TKAs with a minimum of 2-year follow-up. Cumulative incident function (CIF) curves and cause-specific Cox models evaluated the risk of all-cause revision and revision for mechanical loosening, adjusting for body mass index (BMI), sex, age, cruciate retaining (CR) versus posterior stabilized (PS) femoral design, patellar resurfacing, and Charlson's comorbidity index (CCI). Patients with cementless compared with cemented TKA were younger (mean age: 71.9 vs. 73.2 years, <i>p</i> < 0.001), more likely to be male sex (48.8 vs. 39.0%, <i>p</i> < 0.001), more likely to have a CR femoral design (81.1 vs. 45.7%, <i>p</i> < 0.001), less likely to have patellar resurfacing (92.7 vs. 95.0%, <i>p</i> < 0.001), and had a lower CCI (mean: 2.9 vs. 3.1, <i>p</i> < 0.001). Adjusted hazard ratios (HRs) showed no difference in associated risk for all-cause revision (HR: 1.07; 95% confidence interval [CI]: 0.92-1.24; <i>p</i> = 0.382) or revision for mechanical loosening (HR: 1.38; 95% CI: 0.9-2.12; <i>p</i> = 0.14) for cementless versus cemented TKA. Our results suggest that current selective use of cementless fixation for TKA in patients aged ≥65 years in the United States is not associated with an increased risk of revision. While encouraging, further study is necessary to establish indications for use in this age group prior to broader adoption in this patient population. LEVEL OF EVIDENCE:  Therapeutic Level III.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"130-135"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141093516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the Addition of a Tibial Stem Extender in Total Knee Arthroplasty Decrease Risk of Aseptic Loosening in Patients with Obesity? An Analysis from the American Joint Replacement Registry.","authors":"Alexandra L Hohmann, Alexander A Linton, Brooke R Olin, Gabriel L Furey, Isabella Zaniletti, Ayushmita De, Yale A Fillingham","doi":"10.1055/a-2411-0721","DOIUrl":"10.1055/a-2411-0721","url":null,"abstract":"<p><p>Mechanical loosening is a leading cause of failure of total knee arthroplasties (TKAs) for which obesity may be a risk factor. With rising rates of obesity and increasing incidence of TKA, the identification of factors to mitigate this cause of failure is necessary. The purpose of this study is to determine if the use of a tibial stem extender (TSE) decreases the risk of mechanical loosening in patients with obesity undergoing TKA. The American Joint Replacement Registry and linked Centers for Medicare & Medicaid Services claims database were utilized to identify a patient cohort with a body mass index (BMI) of 30 kg/m² or greater and age 65 years or older who underwent primary elective TKA between 2012 and 2021. Patients were divided into cohorts based on obesity class and TSE utilization. The estimated association of TSE use, BMI categories, and covariates with the risk of revisions for mechanical loosening in both unadjusted and adjusted settings was determined. Hazard ratios and their 95% confidence intervals for the risk of mechanical loosening were calculated. A total of 258,775 TKA cases were identified. A total of 538 of 257,194 (0.21%) patients who did not receive a TSE and one patient out of 1,581 (0.06%) with a TSE were revised for mechanical loosening. In adjusted analysis, TSE use was not protective against mechanical loosening and BMI > 40 was not a significant risk factor. Use of a TSE was not found to be protective against mechanical loosening in patients with obesity; however, analysis was limited by the small number of outcome events in the cohort. Further analysis with a larger cohort of patients with TSE and a longer follow-up time is necessary to corroborate this finding.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"115-121"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leaving the Patella Unresurfaced Does Not Increase the Risk of Short-Term Revision Following Total Knee Arthroplasty: An Analysis from the American Joint Replacement Registry.","authors":"Dencel A García Vélez, Anirudh Buddhiraju, Ryland Kagan, Isabella Zaniletti, Ayushmita De, Harpal S Khanuja, Christopher E Pelt, Vishal Hegde","doi":"10.1055/a-2468-6289","DOIUrl":"10.1055/a-2468-6289","url":null,"abstract":"<p><p>The benefit of patellar resurfacing in total knee arthroplasty (TKA) remains uncertain, with conflicting evidence regarding associated revision rates and clinical outcomes. Although initial studies have reported higher revision rates associated with unresurfaced patellae, recent evidence questions the necessity of routine patellar resurfacing. This study aimed to evaluate the risk of revision following TKA performed with and without patellar resurfacing using data from the American Joint Replacement Registry (AJRR).The AJRR was queried for all patients aged 65 years and older undergoing elective TKA between January 2012 and March 2020 with a minimum 2-year follow-up. Cases were linked using supplemental Centers for Medicare and Medicaid data. Cases with hybrid fixation, highly constrained implants, and revision components were excluded. Patients were categorized into two groups: those with a resurfaced patella and those without. Cumulative incidence function (CIF) curves and cause-specific Cox models were utilized to assess all-cause revision risk, adjusting for sex, age, femoral design (cruciate retaining vs. posterior stabilized), fixation type (cemented vs. cementless), and Charlson Comorbidity Index.Of the 390,304 TKAs with minimum 2-year follow-up in our cohort, 22,829 had no patellar resurfacing performed. Adjusted hazard ratios (HRs) revealed no significant difference in all-cause revision (HR = 0.96, 95% confidence interval [CI]: 0.81-1.13, <i>p</i> = 0.656), revision for mechanical loosening (HR = 1.61 [0.88, 2.93], <i>p</i> = 0.122), or revision for infection (HR = 1.02 [0.79, 1.33], <i>p</i> = 0.860) associated with patellar resurfacing status.Our study found that patients with an unresurfaced patella do not face an increased short-term revision risk following TKA. These findings challenge the necessity of routine patellar resurfacing and underscore the importance of considering other factors, such as femoral design, patient comorbidities, and implant-related variables in revision risk stratification.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"122-129"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Early Adverse Events Following Medial Patellofemoral Ligament Reconstruction.","authors":"Sercan Yalcin, Karrington Seals, Lutul D Farrow","doi":"10.1055/a-2421-5391","DOIUrl":"10.1055/a-2421-5391","url":null,"abstract":"<p><p>The current literature lacks data regarding perioperative complications after medial patellofemoral ligament reconstruction (MPFLr). The objective of this study was to identify the incidence and predictors of adverse events in the first 90 days after MPFLr. Patients undergoing primary MPFLr between January 1, 2010, and December 31, 2019, were included. Predictors of readmission for any reason were identified using a multivariable logistic regression analysis. A total of 140 MPFLrs were included in the final analysis. Of these, 17 patients (12.1%) were admitted in the first 90 days after MPFLr. The most common reason for readmission was pain (7/140, 5%), followed by cellulitis (5/140, 3.5%). The only major complication was pulmonary embolism experienced by one patient (1/140, 0.7%). Univariate logistic regression analysis demonstrated that patients who ever smoked were 4.5 times (<i>p</i> = 0.005) more likely to be readmitted in the first 90 days. Although additional soft-tissue procedures increased the readmission rated by 21% (<i>p</i> = 0.810) and additional chondral procedure increased by 35% (<i>p</i> = 0.568), the multivariable analysis did not reveal a significant difference. Surgeons can use this information to counsel patients on what to expect following MPFLr.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"136-140"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Trochleoplasty versus Tibial Tubercle Osteotomy for Treatment of Patellar Instability Associated with Trochlear Dysplasia: A Systematic Review and Meta-analysis.","authors":"Yehia H Bedeir, Ehsan Akram Ahmed Deghidy","doi":"10.1055/a-2430-0192","DOIUrl":"10.1055/a-2430-0192","url":null,"abstract":"<p><p>This study compared the outcomes of tibial tubercle osteotomy (TTO) and trochleoplasty for the treatment of patellar instability associated with trochlear dysplasia. This was a systematic review of the literature including published articles that describe either trochleoplasty or TTO in addition to medial patellofemoral ligament reconstruction for the surgical treatment of patellar instability associated with trochleoplasty. Main outcomes assessed were Kujala and International Knee Documentation Committee (IKDC) scores, in addition to recurrent instability and complications. Outcome measures reported were provided in a table format and a subjective analysis was performed. Ten studies were included with a total of 362 knees including 132 in the trochleoplasty group and 230 in the TTO group. Mean follow-up ranged from 27.6 to 61.3 months. At the final follow-up, both Kujala and IKDC scores improved significantly in all studies that reported both preoperative and postoperative scores in both groups. There was a total of three instability events in the trochleoplasty group as opposed to 21 in the TTO group. Both procedures, trochleoplasty and TTO, may provide satisfactory functional improvement in patients with patellar instability associated with trochlear dysplasia. However, trochleoplasty may be a better option to minimize the risk of recurrent instability. Level of evidence: level IV, systematic review of level III and level IV studies.</p>","PeriodicalId":48798,"journal":{"name":"Journal of Knee Surgery","volume":" ","pages":"154-162"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}