Surgical treatment of symptomatic patellofemoral malalignment: Do we need an ideal patellofemoral congruency to solve the symptoms?

Background/Aim. The aim of this prospective nonrandomized study was to test functional results of different surgical strategies in the operative treatment of symptomatic patellofemoral malalignment. Our hypothesis was that immediate extensive surgery does not have serious advantage comparing to “ste...

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Main Authors: Apostolović Milan, Vukčević Miodrag, Vučković Vladimir, Vukomanović Boris, Slavković Nemanja, Đuričić Goran, Antonijević Nebojša, Čučilović Oskar
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2018-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501700056A.pdf
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author Apostolović Milan
Vukčević Miodrag
Vučković Vladimir
Vukomanović Boris
Slavković Nemanja
Đuričić Goran
Antonijević Nebojša
Čučilović Oskar
author_facet Apostolović Milan
Vukčević Miodrag
Vučković Vladimir
Vukomanović Boris
Slavković Nemanja
Đuričić Goran
Antonijević Nebojša
Čučilović Oskar
author_sort Apostolović Milan
collection DOAJ
description Background/Aim. The aim of this prospective nonrandomized study was to test functional results of different surgical strategies in the operative treatment of symptomatic patellofemoral malalignment. Our hypothesis was that immediate extensive surgery does not have serious advantage comparing to “step by step” procedure, regarding the main symptoms and functional end result. We wanted to check whether obtaining ideal surgical patellofemoral congruency is an essential prerequisite for subsidence of the major symptoms of patellofemoral malalignment. Methods. The study included 35 patients with patellofemoral malalignment who had persistant major symptoms: patellar pain and slipping, 3 months after nonoperative treatment. Divided into three groups, they all underwent the realignment surgery, but in different extent and sequence: immediate extensive surgery, step by step surgery, and only proximal realignment. Their overall functional scores as well as major symptoms were assessed at the beginning, after the surgery, and during the 3-years follow-up period and then, compared at the end. Results. There was no significant difference in the functional results among the groups, neither at the beginning (p = 0.1318) nor at the end of the study (p = 0.3996), but the results at the beginning compared to those at the end of the study showed a statistically significant difference in all three groups (p1 = 0.005062; p2 = 0.011719; p3 = 0.000352). The same result was in regard to the major symptoms. Conclusion. The study confirmed that insisting on immediate extensive surgery in order to achieve precise and complete congruency of the patellofemoral joint, did not prove its advantage over the less invasive, individual surgical approach concerning functional scores and major symptoms.
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spelling doaj-art-586effc97321450a8071cd0b572e28d42025-08-20T01:56:59ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202018-01-0175121190119610.2298/VSP170227056A0042-84501700056ASurgical treatment of symptomatic patellofemoral malalignment: Do we need an ideal patellofemoral congruency to solve the symptoms?Apostolović Milan0Vukčević Miodrag1Vučković Vladimir2Vukomanović Boris3Slavković Nemanja4Đuričić Goran5Antonijević Nebojša6Čučilović Oskar7Institute for Orthopaedic Surgery „Banjica“, Belgrade + Faculty of Medicine, BelgradeFaculty of Medicine, Belgrade + Clinical Center „Zemun“, ZemunInstitute for Orthopaedic Surgery „Banjica“, BelgradeInstitute for Orthopaedic Surgery „Banjica“, Belgrade + Faculty of Medicine, BelgradeInstitute for Orthopaedic Surgery „Banjica“, Belgrade + Faculty of Medicine, BelgradeUniversity Children`s Hospital, BelgradeFaculty of Medicine, Belgrade + Clinical Center of Serbia, Clinic of Cardiology, BelgradeInstitute for Orthopaedic Surgery „Banjica“, BelgradeBackground/Aim. The aim of this prospective nonrandomized study was to test functional results of different surgical strategies in the operative treatment of symptomatic patellofemoral malalignment. Our hypothesis was that immediate extensive surgery does not have serious advantage comparing to “step by step” procedure, regarding the main symptoms and functional end result. We wanted to check whether obtaining ideal surgical patellofemoral congruency is an essential prerequisite for subsidence of the major symptoms of patellofemoral malalignment. Methods. The study included 35 patients with patellofemoral malalignment who had persistant major symptoms: patellar pain and slipping, 3 months after nonoperative treatment. Divided into three groups, they all underwent the realignment surgery, but in different extent and sequence: immediate extensive surgery, step by step surgery, and only proximal realignment. Their overall functional scores as well as major symptoms were assessed at the beginning, after the surgery, and during the 3-years follow-up period and then, compared at the end. Results. There was no significant difference in the functional results among the groups, neither at the beginning (p = 0.1318) nor at the end of the study (p = 0.3996), but the results at the beginning compared to those at the end of the study showed a statistically significant difference in all three groups (p1 = 0.005062; p2 = 0.011719; p3 = 0.000352). The same result was in regard to the major symptoms. Conclusion. The study confirmed that insisting on immediate extensive surgery in order to achieve precise and complete congruency of the patellofemoral joint, did not prove its advantage over the less invasive, individual surgical approach concerning functional scores and major symptoms.http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501700056A.pdfpatellofemoral malalignmentfunctional scorepatellofemoral pain
spellingShingle Apostolović Milan
Vukčević Miodrag
Vučković Vladimir
Vukomanović Boris
Slavković Nemanja
Đuričić Goran
Antonijević Nebojša
Čučilović Oskar
Surgical treatment of symptomatic patellofemoral malalignment: Do we need an ideal patellofemoral congruency to solve the symptoms?
Vojnosanitetski Pregled
patellofemoral malalignment
functional score
patellofemoral pain
title Surgical treatment of symptomatic patellofemoral malalignment: Do we need an ideal patellofemoral congruency to solve the symptoms?
title_full Surgical treatment of symptomatic patellofemoral malalignment: Do we need an ideal patellofemoral congruency to solve the symptoms?
title_fullStr Surgical treatment of symptomatic patellofemoral malalignment: Do we need an ideal patellofemoral congruency to solve the symptoms?
title_full_unstemmed Surgical treatment of symptomatic patellofemoral malalignment: Do we need an ideal patellofemoral congruency to solve the symptoms?
title_short Surgical treatment of symptomatic patellofemoral malalignment: Do we need an ideal patellofemoral congruency to solve the symptoms?
title_sort surgical treatment of symptomatic patellofemoral malalignment do we need an ideal patellofemoral congruency to solve the symptoms
topic patellofemoral malalignment
functional score
patellofemoral pain
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501700056A.pdf
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