Background: Tibial tubercle osteotomy (TTO) is a surgical procedure for the management of patellofemoral instability (PFI). Tubercle distalization requires a complete osteotomy detachment and has been shown to have an increased rate of certain complications in predominantly adult cohorts. With this study we identify and compare the complication rate of 2 TTO techniques-anteromedializing alone (AM) and anteromedializing with concomitant distalization (AMD) among young patients.
Methods: A retrospective comparative study was conducted from 2010 to 2021 at 2 large tertiary care pediatric hospitals identifying adolescent and young adult patients (<21 years) who presented for surgical treatment of PFI undergoing TTO. Groups were stratified based on the type of TTO: AM and AMD. Demographics and radiographic measures were recorded. Postoperative complications were identified and recorded using the modified Clavien-Dindo-Sink (CDS) classification system. Bivariate testing was conducted to compare variables among treatment groups.
Results: Seventy-six knees undergoing tubercle osteotomy (47 AM and 29 AMD) were identified. Treatment cohorts had similar demographics, mean preoperative CDI, Oswestry-Bristol classification, and Dejour classifications. Median follow-up was similar between both the groups in the AM and AMD groups (P=0.5). The overall complication was 22% (n=17/76) whereas in the AM group and AMD group was 19% (n=9/47) and 27% (n=8/29), respectively (P=0.57). The most common complications observed in both groups were infection and arthrofibrosis. No significant differences between AM and AMD groups were noted with respect to the grade of complication and individual complication rates (P >0.05).
Conclusion: The rate of overall complications was similar to prior adult studies. In this large adolescent cohort, tubercle distalization compared with anteromedial transfer alone did not demonstrate statistically significant differences. Findings from this study help surgeons understand complication rates and improving counselling among adolescent PFI patients being considering for a distalizing TTO.
Study Design: Retrospective comparative study; level of evidence III.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BPO.0000000000002945 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Mortality Trends in Polymyositis and Dermatomyositis in Mexico: A General Population-Based Study From 2000 to 2019.
J Clin Rheumatol
March 2025
Coordinación de Investigación en Salud, Instituto Mexicano del Seguro Social, Puebla, Mexico.
Introduction: Patients with polymyositis and dermatomyositis (PM/DM) are prone to multiple complications that may lead to increased mortality rates. Data about PM/DM mortality in Mexico are lacking.
Objective: The aim of this study was to assess mortality trends in PM/DM in Mexico across 2 decades (2000-2019), overall, by sex, age group, and geographic region.
A Controlled Trial for Preventing Priapism in Sickle Cell Anemia: Hydroxyurea plus Placebo vs Hydroxyurea plus Tadalafil.
Blood
March 2025
Vanderbilt UniversityVanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Nashville, Tennessee, United States.
Recurrent ischemic priapism is a common complication of sickle cell anemia (SCA) and is associated with devastating physical and psychosocial consequences. All previous trials for priapism prevention have failed to demonstrate clear efficacy. We conducted a randomized, controlled, double-blind phase 2 feasibility trial comparing fixed moderate-dose hydroxyurea plus placebo (usual care arm) versus fixed moderate-dose hydroxyurea plus tadalafil (experimental arm) in 64 men (18- 40 years) with at least three episodes of SCA-related priapism in the past 12 months.
View Article and Find Full Text PDFDo Widespread or Selective Invasive Monitoring Increase the Rate of Fasciotomies for Tibial Shaft and Plateau Fractures, or Affect the Incidence of Possible Missed Compartment Syndrome?
J Am Acad Orthop Surg
March 2025
From the Orthopaedic Trauma Service (Ricketts, Sajid, Flanagan, Stang, Maxson, Infante, Shah, and Mir), Florida Orthopaedic Institute, and the Department of Orthopaedics (McCaskey, Maseda, Diaz, and Mir), University of South Florida, Tampa, FL.
Introduction: To report the incidence of lower leg fasciotomies in tibial shaft and plateau fractures and explore the incidence of potential missed acute compartment syndrome (ACS) with widespread, selective, or no invasive monitoring (IM).
Methods: This is a retrospective review of adult patients with diaphyseal tibial fractures (Orthopaedic Trauma Association 42A-C), and proximal tibial fractures (Orthopaedic Trauma Association 41A-C) treated surgically at a Level 1 trauma center from 2001 to 2020. Main outcomes of interest include lower extremity fasciotomy rates and incidence of potential missed ACS (abnormal neurovascular examination, sensory changes, chronic pain, claw toes, or amputation) in diaphyseal and proximal tibial fractures at three time intervals: widespread use of IM (w-IM) (2000 to 2010), selective IM (s-IM) (2011 to 2015), and clinical examination with a high index of suspicion alone without IM (CES), 2016 to 2020.
Reduction of Central Line-Associated Bloodstream Infections on a Transplant Unit.
J Nurs Care Qual
March 2025
Author Affiliations: Director Patient Care-Oncology, Surgery, & Transplant Services, Emory University Hospital, Atlanta, GA (Ms Spinks); Solid Organ Transplant, Unit Nurse Educator, Emory University Hospital, Atlanta, GA (Ms Berhanu); Solid Organ Transplant, Education Coordinator, Emory University Hospital, Atlanta, GA (Mr Buenvenida); Solid Organ Transplant, Unit Director, Emory University Hospital, Atlanta, GA (Ms Henry); Division of Transplantation, Emory University School of Medicine, Atlanta, GA (Dr Lo); and Infection Preventionist, Infection Prevention and Control Department, Emory University Hospital, Atlanta, GA (Dr Yun).
Background: Central line-associated bloodstream infection (CLABSI) is a preventable complication of central venous catheters (CVC) that can result in prolonged hospitalization, increased cost, and mortality.
Local Problem: CLABSI rates in a solid organ transplant unit were above the National Database of Nursing Quality Indicators target.
Methods: Evidence-based CLABSI prevention interventions were implemented using the Plan-Do-Study-Act process.
Spinal Osteotomies for Cervicothoracic Sagittal Imbalance Correction: A Systematic Review and Meta-Analysis.
Global Spine J
March 2025
Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA.
Study DesignSystematic Review.ObjectivesCervicothoracic junction (CTJ) deformities, particularly kyphosis, significantly impact patients' quality of life, causing pain, dysphagia, and inability to maintain horizontal gaze. Various surgical osteotomy techniques are available to correct CTJ kyphosis, but their relative effectiveness and associated complications remain unclear.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!