Complications after knee derotational osteotomies in patients with anterior knee pain and/or patellofemoral instability: a systematic review with meta-analysis
Purpose: Investigate intra- and post-operative complications and revisions following distal femoral and/or high tibial derotational osteotomies to correct rotational malalignments of the lower limb in patients with anterior knee pain (AKP) and/or patellofemoral instability (PFI). Methods: A literatu...
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Bioscientifica
2025-01-01
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| Series: | EFORT Open Reviews |
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| author | Inês Figueiredo Cristina Valente Ricardo Ribeiro Bárbara Ferreira Eluana Gomes Diego Delgado Mikel Sánchez Renato Andrade João Espregueira-Mendes |
| author_facet | Inês Figueiredo Cristina Valente Ricardo Ribeiro Bárbara Ferreira Eluana Gomes Diego Delgado Mikel Sánchez Renato Andrade João Espregueira-Mendes |
| author_sort | Inês Figueiredo |
| collection | DOAJ |
| description | Purpose: Investigate intra- and post-operative complications and revisions following distal femoral and/or high tibial derotational osteotomies to correct rotational malalignments of the lower limb in patients with anterior knee pain (AKP) and/or patellofemoral instability (PFI). Methods: A literature search was conducted on PubMed, EMBASE and Web of Science (until 30 September 2023), including studies reporting complications, reinterventions and revisions following knee derotational osteotomies. Incidence rates were collected for each level of derotational osteotomy (distal femur, high tibia or double-level). A meta-analysis using the Freeman–Tukey double arcsine transformation was conducted to estimate the pooled proportions with their 95% confidence intervals (CIs). Results: Twenty-one studies involving 564 osteotomies (n = 484) were included, with a mean follow-up of 45.6 ± 15.7 months. The overall complication proportion was 7.5% (95% CI: 3.9–11.8%). Postoperative residual AKP was seen in a pooled proportion of 7.6% (95% CI: 0.7–18.8%), and persistent PFI was not common (0.1%; 95% CI: 0.0–1.7%). Intraoperative complications occurred in a pooled proportion of 3.8% (95% CI: 2.4–6.0%), with peroneal nerve injury being the most common (1.3%) after derotational high tibial osteotomy. Reintervention was needed in a pooled proportion of 13.0% (95% CI: 2.9–27.2%), primarily for hardware removal (n = 158; 28.3%). There was a pooled proportion of knees requiring revision procedures of 12.3% (95% CI: 2.6–26.1%). Conclusions: Distal femur and high tibial derotational osteotomies exhibit a considerable incidence of intra- and post-operative complications. Peroneal nerve injury, although infrequent, is a significant complication, underscoring the importance of implementing intraoperative preventive measures during derotational high tibial osteotomy. |
| format | Article |
| id | doaj-art-df8e6994980f4c62884839a177f60e0f |
| institution | Kabale University |
| issn | 2058-5241 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Bioscientifica |
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| series | EFORT Open Reviews |
| spelling | doaj-art-df8e6994980f4c62884839a177f60e0f2025-01-07T17:19:38ZengBioscientificaEFORT Open Reviews2058-52412025-01-01101142710.1530/EOR-2024-00361Complications after knee derotational osteotomies in patients with anterior knee pain and/or patellofemoral instability: a systematic review with meta-analysisInês Figueiredo0Cristina Valente1Ricardo Ribeiro2Bárbara Ferreira3Eluana Gomes4Diego Delgado5Mikel Sánchez6Renato Andrade7João Espregueira-Mendes8School of Medicine, Minho University, Braga, PortugalClínica Espregueira-FIFA Medical Centre of Excellence, Porto, PortugalSchool of Medicine, Minho University, Braga, PortugalSchool of Medicine, Minho University, Braga, PortugalClínica Espregueira-FIFA Medical Centre of Excellence, Porto, PortugalAdvanced Biological Therapy Unit, Hospital Vithas Vitoria, Vitoria-Gasteiz, SpainAdvanced Biological Therapy Unit, Hospital Vithas Vitoria, Vitoria-Gasteiz, SpainClínica Espregueira-FIFA Medical Centre of Excellence, Porto, PortugalSchool of Medicine, Minho University, Braga, PortugalPurpose: Investigate intra- and post-operative complications and revisions following distal femoral and/or high tibial derotational osteotomies to correct rotational malalignments of the lower limb in patients with anterior knee pain (AKP) and/or patellofemoral instability (PFI). Methods: A literature search was conducted on PubMed, EMBASE and Web of Science (until 30 September 2023), including studies reporting complications, reinterventions and revisions following knee derotational osteotomies. Incidence rates were collected for each level of derotational osteotomy (distal femur, high tibia or double-level). A meta-analysis using the Freeman–Tukey double arcsine transformation was conducted to estimate the pooled proportions with their 95% confidence intervals (CIs). Results: Twenty-one studies involving 564 osteotomies (n = 484) were included, with a mean follow-up of 45.6 ± 15.7 months. The overall complication proportion was 7.5% (95% CI: 3.9–11.8%). Postoperative residual AKP was seen in a pooled proportion of 7.6% (95% CI: 0.7–18.8%), and persistent PFI was not common (0.1%; 95% CI: 0.0–1.7%). Intraoperative complications occurred in a pooled proportion of 3.8% (95% CI: 2.4–6.0%), with peroneal nerve injury being the most common (1.3%) after derotational high tibial osteotomy. Reintervention was needed in a pooled proportion of 13.0% (95% CI: 2.9–27.2%), primarily for hardware removal (n = 158; 28.3%). There was a pooled proportion of knees requiring revision procedures of 12.3% (95% CI: 2.6–26.1%). Conclusions: Distal femur and high tibial derotational osteotomies exhibit a considerable incidence of intra- and post-operative complications. Peroneal nerve injury, although infrequent, is a significant complication, underscoring the importance of implementing intraoperative preventive measures during derotational high tibial osteotomy.https://eor.bioscientifica.com/view/journals/eor/10/1/EOR-2024-0036.xmlanterior knee painderotationalfemurosteotomypatellofemoral instabilitytibia |
| spellingShingle | Inês Figueiredo Cristina Valente Ricardo Ribeiro Bárbara Ferreira Eluana Gomes Diego Delgado Mikel Sánchez Renato Andrade João Espregueira-Mendes Complications after knee derotational osteotomies in patients with anterior knee pain and/or patellofemoral instability: a systematic review with meta-analysis EFORT Open Reviews anterior knee pain derotational femur osteotomy patellofemoral instability tibia |
| title | Complications after knee derotational osteotomies in patients with anterior knee pain and/or patellofemoral instability: a systematic review with meta-analysis |
| title_full | Complications after knee derotational osteotomies in patients with anterior knee pain and/or patellofemoral instability: a systematic review with meta-analysis |
| title_fullStr | Complications after knee derotational osteotomies in patients with anterior knee pain and/or patellofemoral instability: a systematic review with meta-analysis |
| title_full_unstemmed | Complications after knee derotational osteotomies in patients with anterior knee pain and/or patellofemoral instability: a systematic review with meta-analysis |
| title_short | Complications after knee derotational osteotomies in patients with anterior knee pain and/or patellofemoral instability: a systematic review with meta-analysis |
| title_sort | complications after knee derotational osteotomies in patients with anterior knee pain and or patellofemoral instability a systematic review with meta analysis |
| topic | anterior knee pain derotational femur osteotomy patellofemoral instability tibia |
| url | https://eor.bioscientifica.com/view/journals/eor/10/1/EOR-2024-0036.xml |
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