nach oben

Knee Surgery, Sports Traumatology, Arthroscopy

Erschienen in:

16.04.2022 | KNEE

The incidence of complications after derotational femoral and/or tibial osteotomies in patellofemoral disorders in adolescents and active young patients: a systematic review with meta-analysis

verfasst von: Vicente Sanchis-Alfonso, Julio Domenech-Fernandez, Joan Ferras-Tarrago, Alejandro Rosello-Añon, Robert A. Teitge

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 10/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To quantify the risk of perioperative and postoperative complications of derotational femoral and/or tibial osteotomies in patellofemoral disorders (anterior knee pain and patellar instability) in adolescents and active young patients.

Methods

MEDLINE, EMBASE, Cochrane and Scopus databases were used to identify studies published from database inception and June 30, 2021. Meta-analysis was performed to pool the rates of complications related to femur and tibia osteotomies. Values of proportion of complications were expressed as proportions and 95% confidence intervals (CI) and then transformed using a Freeman Tukey double arcsine transformation. Meta-regression was used to explore factors that potentially may influence on heterogeneity such as year of publication, quality of the included studies and site of the osteotomy.

Results

The 22 studies identified included a total of 648 derotational osteotomies in 494 patients. Studies consisted of 20 case series (non-comparative) and 2 comparative observational non-randomized cohorts. Tibial osteotomies showed higher risk of complications than femoral osteotomies (random pooled prevalence 9%; 95% CI 4–15% versus 1%; 95% CI 0–5%, respectively, p < 0.01). The meta-regression analysis of the articles showed that the only parameters responsible of the variance in number of complications were the osteotomy site.

Conclusions

Derotational femoral and/or tibial osteotomy is a safe surgical procedure in the treatment of patellofemoral disorders (anterior knee pain and patellar instability) in adolescents and active young people.

Level of evidence

IV.

Bruce WD, Stevens PM (2004) Surgical correction of miserable malalignment syndrome. J Pediatr Orthop 24(4):392–396PubMedCrossRef

Bradburn MJ, Deeks JJ, Berlin JA, Localio AR (2007) Much ado about nothing: a comparison of the performance of meta-analytical methods with rare events. Stat Med 26(1):53–77PubMedCrossRef

Cameron JC, Saha S (1996) External tibial torsion: an underrecognized cause of recurrent patellar dislocation. Clin Orthop Relat Res 328:177–184CrossRef

Chou R, Fu R, Carson S, Saha S, Helfand M (2007) Methodological shortcomings predicted lower harm estimates in one of two sets of studies of clinical interventions. J Clin Epidemiol 60(1):18–28PubMedCrossRef

Cooke TD, Price N, Fisher B, Hedden D (1990) The inwardly pointing knee. An unrecognized problem of external rotational malalignment. Clin Orthop Relat Res 267(260):56–60

Cox DR (1970) The continuity correction. Biometrika 57:217–219CrossRef

Delgado ED, Schoenecker PL, Rich MM, Capelli AM (1996) Treatment of severe torsional malalignment syndrome. J Pediatr Orthop 16(4):484–488PubMedCrossRef

Dickschas J, Harrer J, Pfefferkorn R, Strecker W (2012) Operative treatment of patellofemoral maltracking with torsional osteotomy. Arch Orthop Trauma Surg 132(3):289–298PubMedCrossRef

Dickschas J, Harrer J, Reuter B, Schwitulla J, Strecker W (2015) Torsional osteotomies of the femur. J Orthop Res 33(3):318–324PubMedCrossRef

10.

Dickschas J, Tassika A, Lutter Ch, Harrer J, Strecker W (2017) Torsional osteotomies of the tibia in patellofemoral dysbalance. Orthop Trauma Surg 137(2):179–185CrossRef

11.

DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188PubMedCrossRef

12.

Drexler M, Dwyer T, Dolkart O, Goldstein Y, Steinberg EL, Chakravertty R, Cameron JC (2014) Tibial rotational osteotomy and distal tuberosity transfer for patella subluxation secondary to excessive external tibial 279 torsion: surgical technique and clinical outcome. Knee Surg Sports Traumatol Arthrosc 22(11):2682–2689PubMedCrossRef

13.

Egger M, Schneider M, Davey Smith G (1998) Spurious precision? Meta-analysis of observational studies. BMJ 316(7125):140–144PubMedPubMedCentralCrossRef

14.

Fouilleron N, Marchetti E, Autissier G, Gougeon F, Migaud H, Girard J (2010) Proximal tibial derotation osteotomy for torsional tibial deformities generating patello-femoral disorders. Orthop Traumatol Surg Res 96(7):785–792PubMedCrossRef

15.

Frings J, Krause M, Akoto R, Frosch KH (2019) Clinical results after combined distal femoral osteotomy in patients with patellar maltracking and recurrent dislocations. J Knee Surg 32(9):924–933PubMedCrossRef

16.

Higgins J, Thompson S, Deeks J, Altman D (2003) Measuring inconsistency in meta analyses. BMJ 327:557–560PubMedPubMedCentralCrossRef

17.

Imhoff FB, Cotic M, Liska F, Dyrna FGE, Beitzel K, Imhoff AB, Herbst E (2019) Derotational osteotomy at the distal femur is effective to treat patients with patellar instability. Knee Surg Sports Traumatol Arthrosc 27(2):652–658PubMedCrossRef

18.

Iobst CA, Ansari A (2018) Femoral derotational osteotomy using a modified intramedullary nail technique. Tech Orthop 33(4):267–270PubMedCrossRef

19.

Leonardi F, Rivera F, Zorzan A, Ali SM (2014) Bilateral double osteotomy in severe torsional malalignment syndrome: 16 years follow-up. J Orthop Traumatol 15(2):131–136PubMedCrossRef

20.

Manilov R, Chahla J, Maldonado S, Altintas B, Manilov M, Zampogna B (2020) High tibial derotation osteotomy for distal extensor mechanism alignment in patients with squinting patella due to increased external tibial torsion. Knee 27(6):1931–1941PubMedCrossRef

21.

Meister K, James SL (1995) Proximal tibial derotation 303 osteotomy for anterior knee pain in the miserably malaligned extremity. Am J Orthop (Belle Mead NJ) 24(2):149–155

22.

Naqvi G, Stohr K, Rehm A (2017) Proximal femoral derotation osteotomy for idiopathic excessive femoral anteversion and intoeing gait. SICOT J 3:49PubMedPubMedCentralCrossRef

23.

Nelitz M, Dreyhaupt J, Robert S, Williams M, Dornacher D (2015) Combined supracondylar femoral derotation osteotomy and patellofemoral ligament reconstruction for recurrent patellar dislocation and severe femoral anteversion syndrome: surgical technique and clinical outcome. Int Orthop 39(12):2355–2362PubMedCrossRef

24.

Nogueira MP, Paley D, Bhave A, Herbert A, Nocente C, Herzenberg JE (2003) Nerve lesions associated with limb- lengthening. J Bone Joint Surg (Am) 85-A(8):1502–1510CrossRef

25.

Onishi S, Iseki T, Kanto R, Kanto M, Kambara S, Yoshiya S, Tachibana T, Nakayama H (2020) Incidence of and risk factors for deep vein thrombosis in patients undergoing osteotomies around the knee comparative analysis of different osteotomy types. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-020-06326-5PubMedCrossRef

26.

Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD (2021) PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ 372:n160. https://doi.org/10.1136/bmj.n160PubMedPubMedCentralCrossRef

27.

Paulos L, Swanson SC, Stoddard GJ, Barber-Westin S (2009) Surgical correction of limb malalignment for instability of the patella: a comparison of 2 techniques. Am J Sports Med 37(7):1288–1300PubMedCrossRef

28.

Payne J, Rimmke N, Schmitt LC, Flanigan DC, Magnussen RA (2015) The incidence of complications of tibial tubercle osteotomy: a systematic review. Arthroscopy 31(9):1819–1825PubMedCrossRef

29.

Ries C, Boese CK, Ott N, Doerner J, Muller LP, Hackl M (2021) Intra-individual variance of bilateral femoro-tibial leg rotation: a CT study of 105 healthy subjects. Knee Surg Sports Traumatol Arthrosc 29(4):1106–1113PubMedCrossRef

30.

Saini P, Loke YK, Gamble C, Altman DG, Williamson PR, Kirkham JJ (2014) Selective reporting bias of harm outcomes within studies: findings from a cohort of systematic reviews. BMJ 349:g6501. https://doi.org/10.1136/bmj.g6501PubMedPubMedCentralCrossRef

31.

Schmaranzer F, Lerch TD, Siebenrock KA (2019) Differences in femoral torsion among various measurement methods increase in hips with excessive femoral torsion. Clin Orthop Relat Res 477(5):1073–1083PubMedPubMedCentralCrossRef

32.

Server F, Miralles RC, Garcia E, Soler JM (1996) Medial rotational tibial osteotomy for patellar instability secondary to lateral tibial torsion. Int Orthop 20(3):153–158PubMedCrossRef

33.

Sokol DK, Wilson J (2008) What is a surgical complication? World J Surg 32(6):942–944PubMedCrossRef

34.

Stambough JB, Davis L, Szymanski DA, Smith JC, Schoenecker PL, Gordon JE (2018) Knee pain and activity outcomes after femoral derotation osteotomy for excessive femoral anteversion. J Pediatr Orthop 38(10):503–509PubMedCrossRef

35.

Stevens PM, Gililland JM, Anderson LA, Mickelson JB, Nielson J, Klatt JW (2014) Success of torsional correction surgery after failed surgeries for patellofemoral pain and instability. Strateg Trauma Limb Reconstr 9(1):5–12CrossRef

36.

Teitge RA (2008) Patellofemoral syndrome a paradigm for current surgical strategies. Orthop Clin N Am 39:287–311CrossRef

37.

Teitge RA (2012) Does lower limb torsion matter? Tech Knee Surg 11:137–146CrossRef

38.

Teitge RA (2018) The power of transverse plane limb mal-alignment in the genesis of anterior knee pain—clinical relevance. Ann Joint 3:70CrossRef

39.

Thompson SG, Higgins JP (2002) How should meta-regression analyses be undertaken and interpreted? Stat Med 21:1559–1573PubMedCrossRef

40.

Tian G, Yang G, Zuo L, Li F, Wang F (2020) 349 Femoral derotation osteotomy for recurrent patellar dislocation. Orthop Trauma Surg 140(12):2077–2084CrossRef

41.

Yoshioka Y, Cooke TD (1987) Femoral anteversion: assessment based on function axes. J Orthop Res 5(1):86–91PubMedCrossRef

42.

Yoshioka Y, Siu DW, Scudamore RA (1989) Tibial anatomy and functional axes. J Orthop Res 7(1):132–137PubMedCrossRef

43.

Zhang Z, Song G, Li Y, Zheng T, Ni Q, Feng H, Zhang H (2021) Medial patellofemoral ligament reconstruction with or without derotational distal femoral osteotomy in treating recurrent patellar dislocation with increased femoral anteversion: a retrospective comparative study. Am J Sports Med 49(1):200–206PubMedCrossRef

44.

Zorzela L, Loke YK, Ioannidis JP, Golder S, Santaguida P, Altman DG, Moher D, Vohra S, PRISMAHarms Group (2016) PRISMA harms checklist: improving harms reporting in systematic reviews. BMJ 352:i157. https://doi.org/10.1136/bmj.i157PubMedCrossRef

Titel: The incidence of complications after derotational femoral and/or tibial osteotomies in patellofemoral disorders in adolescents and active young patients: a systematic review with meta-analysis
verfasst von: Vicente Sanchis-Alfonso
Julio Domenech-Fernandez
Joan Ferras-Tarrago
Alejandro Rosello-Añon
Robert A. Teitge
Publikationsdatum: 16.04.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 10/2022
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-022-06964-x

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Traumatologische Notfälle Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Internistische Arzneimitteltherapie Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

The incidence of complications after derotational femoral and/or tibial osteotomies in patellofemoral disorders in adolescents and active young patients: a systematic review with meta-analysis