Document Detail


Patellofemoral instability in athletes: treatment via modified Fulkerson osteotomy and lateral release.
MedLine Citation:
PMID:  20212100     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Surgical treatment of patellofemoral instability can successfully diminish episodes of subluxation and dislocation, as well as symptoms of pain and instability. HYPOTHESIS: Surgical treatment of lateral patellar instability in a strictly athletic population will facilitate return to sports. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: From 1999 to 2004, 41 Fulkerson osteotomies combined with an arthroscopic lateral release were performed in 34 athletes for patellofemoral instability. Three patients were lost to follow-up. All patients participated in sports at least 3 times per week in at least one sport for 4 months of the year. There were 4 male and 30 female patients; 7 patients underwent bilateral, staged procedures. There were 14 high school, 12 collegiate, and 8 recreational athletes. Results were obtained by an independent examiner. RESULTS: The mean age was 20.05 years (range, 14-54 years) with a mean follow-up of 46 months (range, 22-71 months). Patients averaged 1.3 dislocations before reconstruction (range, 0-6). The average Lysholm score was 91.8 (range, 67-100) at follow-up. The International Knee Documentation Committee (IKDC) scores were A (normal) in 27 knees, B (near normal) in 12, and C (abnormal) in 2. Seventeen patients had symptomatic hardware removed at an average of 8 months. There were 2 complications: one saphenous neuroma that resolved, and one recurrent dislocation in a patient later diagnosed with Ehlers-Danlos syndrome. CONCLUSION: This series is the largest to date documenting the successful treatment of patellofemoral instability in athletes with concomitant Fulkerson osteotomy and arthroscopic lateral release. Forty-nine percent of patients in our series required removal of screws from the osteotomy site.
Authors:
Fotios Paul Tjoumakaris; Brian Forsythe; James P Bradley
Publication Detail:
Type:  Journal Article     Date:  2010-03-08
Journal Detail:
Title:  The American journal of sports medicine     Volume:  38     ISSN:  1552-3365     ISO Abbreviation:  Am J Sports Med     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-03     Completed Date:  2010-07-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609541     Medline TA:  Am J Sports Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  992-9     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Penn Sports Medicine, Philadelphia, Pennsylvania 15203, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Arthroscopy / methods
Athletic Injuries / surgery*
Ehlers-Danlos Syndrome / diagnosis
Female
Humans
Joint Instability / surgery*
Male
Middle Aged
Orthopedic Procedures / methods*
Osteotomy / methods*
Patellar Dislocation / diagnosis
Patellofemoral Joint / surgery*
Postoperative Complications / diagnosis
Prospective Studies
Range of Motion, Articular
Reconstructive Surgical Procedures / methods*
Recovery of Function
Recurrence
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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