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Prevalence of osteoarthritis and clinical results after the Elmslie-Trillat procedure: a retrospective long-term follow-up

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Abstract

Purpose

Tibial tuberosity medialisation may be followed by osteoarthritis in the long term due to increased patellofemoral contact pressure and altered knee joint kinematics. We aimed to (1) systematically assess the grades of tibiofemoral and patellofemoral osteoarthritis ten to 30 years after the Elmslie-Trillat procedure and (2) to evaluate long-term knee function and activities of daily living.

Methods

A total of 26 patients (30 knees) were re-evaluated at a minimum follow-up of 12.3 years (mean 20.9 ± 4.1 years). Osteoarthritis was graded according to Kellgren and Lawrence (K/L) and Sperner. All patients were clinically evaluated using the Knee Society Score (KSS) and Knee injury and Osteoarthritis Outcome Score (KOOS). Radiographic data were compared to an age-, sex- and body mass index-matched control group of healthy patients.

Results

Radiographic evaluation revealed seven cases (23.3 %) with advanced osteoarthritis (K/L and Sperner grades 3 and 4). However, the observed differences from the matched cohort were not statistically significant (P = 0.189). A positive correlation was found between the age at index procedure and tibiofemoral osteoarthritis at follow-up (P = 0.013). Patient satisfaction was relatively high, showing a mean KSS of 89.9 (knee score) and 94.8 (function score), and a mean KOOS of 78.7. However, we noted four cases of frequent patellar re-dislocations and three total knee arthroplasties.

Conclusions

The Elmslie-Trillat procedure was associated with several cases of advanced tibiofemoral and patellofemoral osteoarthritis in the long term, especially if the procedure was performed late. Clinical results were still good to excellent in the majority of patients despite some observed cases of re-dislocations and decreased ability to perform sports.

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Acknowledgments

We thank Mrs. Helka Barna, M.D. and Mrs. Alexandra Fochtmann, M.D. for their assistance in data collection.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Pediatric Orthopedics, Deformity Correction and Adult Foot and Ankle Surgery, Orthopedic Hospital Speising, Speisingerstrasse 109, 1130, Vienna, Austria

    Sebastian Farr, Franz Grill & Rudolf Ganger

  2. Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria

    Dominique Huyer

  3. Department of Orthopedic Surgery, University Hospital Graz, Auenbrugger Platz 1, 8036, Graz, Austria

    Patrick Sadoghi

  4. Orthopedic Department, Barmherzige Brüder Hospital, Johannes von Gott-Platz 1, 7000, Eisenstadt, Austria

    Martin Kaipel

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  1. Sebastian Farr
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  2. Dominique Huyer
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  3. Patrick Sadoghi
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  4. Martin Kaipel
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  5. Franz Grill
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  6. Rudolf Ganger
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Correspondence to Sebastian Farr.

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Farr, S., Huyer, D., Sadoghi, P. et al. Prevalence of osteoarthritis and clinical results after the Elmslie-Trillat procedure: a retrospective long-term follow-up. International Orthopaedics (SICOT) 38, 61–66 (2014). https://doi.org/10.1007/s00264-013-2083-2

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  • DOI: https://doi.org/10.1007/s00264-013-2083-2

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