Background: Although biomechanical and clinical studies have reported adverse effects on the patellofemoral joint after medial open-wedge high tibial osteotomy (MOWHTO), there is a paucity of literature that describes outcomes longer than midterm follow-up.
Purpose: We aimed to evaluate the mid- to long-term radiologic and clinical outcomes of the patellofemoral joint after MOWHTO and to assess whether radiologic deterioration of the patellofemoral joint affected clinical outcomes or survivorship after MOWHTO.
Study Design: Case series; Level of evidence, 4.
Methods: We retrospectively reviewed 170 knees that underwent MOWHTO and had a minimum 5-year follow-up. In radiologic evaluation, serial postoperative changes in the patellofemoral joint compared with the preoperative status were evaluated on the Merchant view according to the Kellgren-Lawrence grade. The American Knee Society (AKS) score, Knee injury and Osteoarthritis Outcome Score (KOOS), Kujala score, incidence of anterior knee pain, and survivorship were used to assess clinical outcomes. Using radiologic assessment of the patellofemoral joint, we divided the patients into a radiologic progression group and a radiologic nonprogression group to evaluate whether radiologic progression of patellofemoral arthritis affected long-term clinical outcomes and survivorship after MOWHTO.
Results: The mean follow-up period was 96.3 months (range, 60-163 months). Arthritic progression of the patellofemoral joint on the Merchant view was observed in 44.9%, 56.3%, 66.0%, and 84.0% of the cases at 5, 7, 9, and 11 years, respectively. Clinical outcomes such as AKS scores and KOOS significantly improved after MOWHTO ( < .001) at the latest follow-up. The incidence of anterior knee pain was 5.3% (9/170 knees). One knee (0.6%) underwent conversion to TKA due to progressive medial osteoarthritis, so the survival rate was 99.4% at a mean follow-up of 96.3 months. Despite patellofemoral degeneration over time, there were no significant differences in clinical outcomes or survivorship between patients with and without radiologic progression at the latest follow-up.
Conclusion: Although degeneration of the patellofemoral joint was observed with time after MOWHTO, the related symptoms were minimal and arthritic changes in the patellofemoral joint did not affect the clinical outcomes or survivorship after MOWHTO over a mid- to long-term follow-up.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1177/03635465221113324 | DOI Listing |
Adhesions in the deep infrapatellar region may occur as iatrogenic complications (e.g., after bone-patellar tendon-bone grafting), as part of arthrofibrosis or infrapatellar contracture syndrome, or owing to specific diseases such as Osgood-Schlatter disease.
View Article and Find Full Text PDFOrthop Traumatol Surg Res
December 2024
Department of Orthopedic and Trauma Surgery, Centre Hospitalier de Versailles, Île-de-France Ouest University, 177 Rue de Versailles, 78150 Le Chesnay, France. Electronic address:
Purpose: To determine in the long-term the rate of osteoarthritis of recession wedge trochleoplasty performed in patients with high-grade trochlear dysplasia and recurrent patellar dislocations. The hypothesis was that the rate of secondary osteoarthritis was low.
Methods: Fifteen consecutive patients (17 knees) undergoing a recession wedge trochleoplasty surgery for recurrent patellar dislocation were retrospectively included.
Cochrane Database Syst Rev
December 2024
Department of Trauma & Orthopaedics, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK.
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the benefits and harms of injury prevention programmes on anterior cruciate ligament injuries.
View Article and Find Full Text PDFGait Posture
December 2024
Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, China. Electronic address:
Background: Most running biomechanics studies have focused on either the patellofemoral joint (PFJ) or Achilles tendon (AT) alone, generating fragmented understanding of how these structures interact as components of an integrated kinetic chain during running. This study was to investigate concurrent biomechanical changes in the PFJ and AT in recreational runners.
Methods: The recreational runners who are accustomed to run with rearfoot strike (RFS, n = 15) and forefoot strike (FFS, n = 15) patterns were recruited.
Curr Opin Pediatr
February 2025
Hospital for Special Surgery, New York, New York.
Purpose Of Review: Patella alta, which describes an abnormally proximally positioned patella, has become of particular interest as it has been identified as a potential factor in patellofemoral instability (PFI) and other common pediatric orthopedic conditions. The purpose of this review is to describe the condition, measuring techniques, and its association with pediatric orthopedic conditions, and to evaluate methods of correction of patella alta.
Recent Findings: Recent literature has explored the etiology of patella alta by investigating patellar height as age increases, with inconclusive findings as to whether the condition is congenital or acquired over time.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!