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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

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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.

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Authors and Affiliations

  1. Hospital Arnau de Vilanova-Lliria de Valencia, Valencia, Spain

    Vicente Sanchis-Alfonso, Julio Domenech-Fernandez, Joan Ferras-Tarrago & Alejandro Rosello-Añon

  2. Universidad Católica de Valencia, Valencia, Spain

    Julio Domenech-Fernandez

  3. Emeritus Professor, Wayne State University, Detroit, USA

    Robert A. Teitge

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  1. Vicente Sanchis-Alfonso
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  2. Julio Domenech-Fernandez
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Correspondence to Vicente Sanchis-Alfonso.

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Sanchis-Alfonso, V., Domenech-Fernandez, J., Ferras-Tarrago, J. et al. 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. Knee Surg Sports Traumatol Arthrosc 30, 3515–3525 (2022). https://doi.org/10.1007/s00167-022-06964-x

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