A Combined Closing Wedge Distal Femoral Osteotomy and Medial Reefing Procedure for Recurrent Patellar Dislocation with Genu Valgum.
10.3349/ymj.2017.58.4.878
- Author:
Chong Bum CHANG
1
;
Gautam M SHETTY
;
Jong Seong LEE
;
Young Chan KIM
;
Jae Ho KWON
;
Kyung Wook NHA
Author Information
1. Department of Orthopedic Surgery, Seoul National University, Boramae Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Patellar instability;
distal femoral osteotomy;
genu valgum;
medial reefing
- MeSH:
Congenital Abnormalities;
Follow-Up Studies;
Genu Valgum*;
Knee;
Osteotomy*;
Patellar Dislocation*;
Weight-Bearing
- From:Yonsei Medical Journal
2017;58(4):878-883
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Recurrent patellar dislocation is often associated with genu valgum. The purpose of this study was to analyze the short-term results of single-incision, closing-wedge distal femoral osteotomy (CWDFO) combined with medial reefing and lateral release for recurrent patellar instability with genu valgum. MATERIALS AND METHODS: Combined CWDFO/medial reefing/lateral release was performed on 10 knees. Clinical evaluation was based on pre- and postoperative Knee Society Score (KSS) and Kujala patellofemoral score. Radiographic evaluation was performed with reference to the weight-bearing line (WBL), the femorotibial angle (FTA), and the mechanical lateral distal femoral angles in the knee-standing view. RESULTS: At a mean follow-up of 20±11.7 months (range, 12–42 months), KSS scores improved significantly, from 46.7±5.2 preoperatively to 87±4.4 postoperatively (p<0.001), as did the Kujala score, from 44±8 preoperatively to 86.6±6.8 postoperatively (p<0.001). The WBL decreased significantly, from 76±7% preoperatively to 41±11% postoperatively (p<0.001). The FTA was improved significantly, from 12.7±1.7° preoperatively to 4±4° postoperatively (p<0.001), as was the mLDFA, from 83±4° preoperatively to 91±1.3° postoperatively (p<0.001). CONCLUSION: Use of single-incision CWDFO combined with medial reefing and lateral release prevents patellar dislocation, corrects deformity, and improves clinical outcomes.
