Titre :

Complications and outcomes of trochleoplasty for patellofemoral instability: A systematic review and meta-analysis of 1000 trochleoplasties.

Auteur(s) :

Leclerc, Jean-Thomas [Auteur]
CIC CHU ( Lille)/inserm
Dartus, Julien [Auteur]
CIC CHU ( Lille)/inserm
Labreuche, Julien [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Martinot, Pierre [Auteur]
CIC CHU ( Lille)/inserm
Galmiche, Romain [Auteur]
CIC CHU ( Lille)/inserm
Migaud, Henri [Auteur]
Physiopathologie des Maladies Osseuses Inflammatoires (PMOI) - ULR 4490
pasquier, gilles [Auteur]
Physiopathologie des Maladies Osseuses Inflammatoires (PMOI) - ULR 4490
Putman, Sophie [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Titre de la revue :

Orthopaedics & traumatology, surgery & research : OTSR

Nom court de la revue :

Orthop Traumatol Surg Res

Pagination :

103035

Date de publication :

2021-08-05

ISSN :

1877-0568

Mot(s)-clé(s) en anglais :

Complications
Patellar dislocation
Patellofemoral instability
Trochlear osteotomy
Trochleoplasty

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Trochleoplasty is an effective patellar stabilization procedure; however, it is associated with a risk of complications that cannot be ignored. Prior systematic reviews on this topic did not include more recent studies ...
Lire la suite >Trochleoplasty is an effective patellar stabilization procedure; however, it is associated with a risk of complications that cannot be ignored. Prior systematic reviews on this topic did not include more recent studies reporting important outcomes, particularly the long-term results of lateral elevation trochleoplasty. This led us to carry out a new meta-analysis of the various trochleoplasty procedures to specify: (1) the recurrence rate of patellofemoral dislocation; (2) the complication rates and; (3) the clinical outcomes. Studies reporting complications and clinical outcomes of trochleoplasty, whether or not it was combined with other procedures for patellofemoral instability, were identified in the MEDLINE, Embase, Scopus, Cochrane Library, Web of Science databases and by searching the grey literature. The primary endpoint was the recurrence of patellofemoral dislocation while the secondary endpoints were objective patellofemoral instability without dislocation, stiffness, patellofemoral osteoarthritis, subsequent surgeries and various clinical outcome scores. The results were combined in a random-effects model (weighing factor: inverse variance) when the heterogeneity was less than 80%. Twenty-eight studies were included: 5 featured lateral elevation trochleoplasty, 10 about the Dejour deepening trochleoplasty, 12 about the Bereiter deepening trochleoplasty and 1 about the recession wedge trochleoplasty. A total of 1000 trochleoplasty procedures were done in 890 patients who had a follow-up of 1 to 25 years. There were 24 cases of recurrent dislocation (24/994 [2.4%]; this outcome was not reported for 6 trochleoplasties). The Dejour deepening trochleoplasty was the most effective with only 1 recurrence in 349 knees (0.28%). For the other complications, residual patellar instability without dislocation occurred in 82 of 754 knees (8% [95% CI: 3-14%]), patellofemoral osteoarthritis in 117 of 431 knees (27%), stiffness in 59 of 642 knees (7% [95% CI: 3-12%]) and the need for subsequent surgery in 151 of 904 knees (17%). This study found a low recurrence rate for patellofemoral dislocation and residual instability. The incidence of stiffness, patellofemoral osteoarthritis and subsequent surgery remains high but differs greatly between studies. This meta-analysis showed a very large disparity between studies for most complications, which justifies the need for randomized and comparative studies to establish the role of trochleoplasty procedures in the treatment algorithm for patellar instability. IV; systematic review and meta-analysis.Lire moins >

Langue :

Anglais

Comité de lecture :

Oui

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
CHU Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Date de dépôt :

2021-10-08T15:48:47Z
2021-10-22T09:30:10Z