Distal derotational femoral osteotomy combined with knee extension device reconstruction for adolescent habitual patellar dislocation with severe lower limb torsional deformity
10.3760/cma.j.cn121113-20250220-00166
- VernacularTitle:股骨远端去旋转截骨联合伸膝装置重建术治疗合并下肢严重扭转畸形的青少年习惯性髌骨脱位
- Author:
Chao FENG
1
;
Lin HUANG
;
Lianyang LIN
;
Shengzhong WU
;
Yukun WANG
;
Yuan GUO
;
Xuemin LYU
;
Zheng YANG
Author Information
1. 首都医科大学附属北京积水潭医院（国家骨科医学中心）小儿骨科，北京 100035
- Publication Type:Journal Article
- Keywords:
Patellar dislocation;
Femoral anteversion angle;
Distal derotational femoral osteotomy;
Patellofemoral joint;
Retinacular release
- From:
Chinese Journal of Orthopaedics
2025;45(10):654-661
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the surgical technique and initial outcomes of distal derotational femoral osteotomy (DDFO) combined with knee extension device reconstruction in adolescents with habitual patellar dislocation and severe lower limb torsional deformity.Methods:A retrospective study was conducted on 10 adolescent patients (12 knees) treated at Beijing Jishuitan Hospital and its Guizhou branch from June 2016 to June 2022. There were 6 males and 4 females with an average age of 12.0±1.5 years (range: 10.0-14.5 years) Surgical treatment included DDFO and knee extension device reconstruction (lateral retinacular release, medial retinacular plication, Roux-Goldthwait distal realignment, and MPFL reconstruction). Clinical outcomes were assessed using Lysholm scores, incidence of redislocation and complications, and imaging parameters (lateral patellofemoral angle, Insall-Salvati index, TT-TG distance, and femoral anteversion angle) preoperatively and at 1 year postoperatively.Results:All 12 knees were successfully operated on, with an average surgery time of 2.0±0.5 h (range 1.0-2.5 h), intraoperative blood loss of 47.1±17.1 ml (range 20-80 ml), and follow-up time of 46.2±18.7 months (range 24-72 months). The Lysholm knee score improved from 58.25±8.80 preoperatively to 89.17±5.32 at final follow-up ( t=-9.096, P<0.001) with significant difference. The lateral patellofemoral angle improved from -64.92±4.68 preoperatively to 6.08±2.27 at final follow-up ( t=39.178, P<0.001) with significant difference. The femoral anteversion angle decreased from 34.08±3.06 preoperatively to 14.50±2.65 at final follow-up ( t=16.916, P<0.001) with significant difference. No patellar redislocation, skin necrosis, wound infection, or limited joint mobility occurred during follow-up. Conclusion:DDFO combined with knee extension device reconstruction is an effective and safe treatment for adolescent habitual patellar dislocation with severe torsional deformity, resulting in significant clinical and radiographic improvement with low complication rates.
