Changes in Patellar Morphology Following Soft Tissue Surgical Correction of Recurrent Patellar Dislocation in Children With Low-grade Trochlear Dysplasia

2021 ◽  
Author(s):  
Conglei Dong ◽  
Yanyang Wang ◽  
Chao Zhao ◽  
Jinghui Niu ◽  
Wei lin ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Patellar Dislocation ◽  
Trochlear Dysplasia ◽  
Morphological Characteristics ◽  
Surgical Correction ◽  
Low Grade ◽  
Recurrent Patellar Dislocation ◽  
The Mean ◽  
Patellar Morphology

Abstract Purpose: Studies indicated that patellofemoral joint dysplasia could be caused by patellar dislocation. The purpose of the study was to investigate the changes in patellar morphology following soft tissue surgical correction of recurrent patellar dislocation in children with low-grade trochlear dysplasia.Methods: The prospective study was performed between November 2007 and December 2012. Finally, 25 cases, with the mean age of 8.4 years (range from 7 to 10 years), were admitted to our study. All patients were diagnosed as bilateral recurrent patellar dislocation associated with femoral trochlear dysplasia. The knee that had suffered an injury or dislocated most frequently was treated with medial patellar retinacular plasty (Group S). The contralateral knee, which served as a control was treated conservatively (Group C). Axial CT scans were undertaken in all patients to assess the patellar morphological characteristics on a particular axial image which was established at the point with the greatest patellar width based on measurements preoperatively and at the final follow-up.Results: Preoperatively, there were no statistically significant differences between the patellar morphology in the two groups (P>0.05). Many radiological parameters of patellar morphology were significantly different between the two groups at the final follow-up, including well-known parameters, such as the mean patellar width (Group S, 40.58 mm (SD 1.26); Group C, 36.41 mm (SD 1.17); p < 0.001), the mean patellar thickness (Group S, 11.59 mm (SD 0.74); Group C, 9.38 mm (SD 0.56); p < 0.001) and the mean wiberg index (Group S, 0.54 (SD 0.06); Group C, 0.72 (SD 0.08); p < 0.001). Little known parameters such as the ratio of length of lateral patella to medial patella (Group S, 1.26 (SD 0.17); Group C, 1.69 (SD 0.21); p < 0.001), which is a measurement of facet asymmetry. However, the wiberg angle was not significantly different between the two groups (Group S, 128.63° (SD 9.05); Group C, 125.47° (SD 13.96); p > 0.05) at the final follow-up.Conclusions: The patellar morphology can be significantly improved by early (before epiphyseal closure) soft tissue surgical correction in children with patellar instability associated with low-grade femoral trochlear dysplasia (Dejour A and B).

Changes in femoral trochlear morphology following surgical correction of recurrent patellar dislocation associated with trochlear dysplasia in children

2018 ◽  
Vol 100-B (6) ◽  
pp. 811-821 ◽  
Author(s):  
K. Fu ◽  
G. Duan ◽  
C. Liu ◽  
J. Niu ◽  
F. Wang
Keyword(s):  
Patellar Dislocation ◽  
Trochlear Dysplasia ◽  
Morphological Characteristics ◽  
Groove Depth ◽  
Surgical Correction ◽  
Trochlear Groove ◽  
Recurrent Patellar Dislocation ◽  
Sulcus Angle ◽  
The Mean

Aims The aim of this study was to investigate the changes in femoral trochlear morphology following surgical correction of recurrent patellar dislocation associated with trochlear dysplasia in children. Patients and Methods A total of 23 patients with a mean age of 9.6 years (7 to 11) were included All had bilateral recurrent patellar dislocation associated with femoral trochlear dysplasia. The knee with traumatic dislocation at the time of presentation or that had dislocated most frequently was treated with medial patellar retinacular plasty (Group S). The contralateral knee served as a control and was treated conservatively (Group C). All patients were treated between October 2008 and August 2013. The mean follow-up was 48.7 months (43 to 56). Axial CT scans were undertaken in all patients to assess the trochlear morphological characteristics on a particular axial image which was established at the point with the greatest epicondylar width based on measurements preoperatively and at the final follow-up. Results Preoperatively, there were no statistically significant differences between the trochlear morphology in the two groups (sulcus angle, p 0.852; trochlear groove depth, p 0.885; lateral trochlear inclination, p 0.676; lateral-to-medial facet ratio, p 0.468; lateral condylar height, p 0.899; medial condylar height, p 0.816). Many radiological parameters of trochlear morphology were significantly different between the two groups at the final follow-up, including well-known parameters, such as the mean sulcus angle (Group S, 146.27° (sd 7.18); Group C, 160.61° (sd 9.29); p < 0.001), the mean trochlear groove depth (Group S, 6.25 mm (sd 0.41); Group C, 3.48 mm (sd 0.65); p < 0.001) and the mean lateral trochlear inclination (Group S, 20.99° (sd 3.87); Group C, 12.18° (sd 1.85); p < 0.001). Lesser known parameters such as the ratio of the lateral to medial trochlear length (Group S, 1.46 (sd 0.19); Group C, 2.14 (sd 0.42); p < 0.001), which is a measurement of facet asymmetry, and the lateral and medial condylar height were also significantly different between the two groups (p < 0.001). Conclusion The femoral trochlear morphology can be improved by early (before epiphyseal closure) surgical correction in children with recurrent patellar dislocation associated with femoral trochlear dysplasia. Cite this article: Bone Joint J 2018;100-B:811–21.

scholarly journals Changes in patellar morphology following surgical correction of recurrent patellar dislocation in children

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Weifeng Li ◽  
Qian Wang ◽  
Hui Li ◽  
Shunyi Wang
Keyword(s):  
Patellar Dislocation ◽  
Morphological Characteristics ◽  
Surgical Correction ◽  
Ct Scans ◽  
Control Group ◽  
Recurrent Patellar Dislocation ◽  
Radiological Parameters ◽  
Significant Difference ◽  
Patellar Morphology

Abstract Background The aim of this study was to evaluate patellar morphological changes following surgical correction of recurrent patellar dislocation in children. Methods A total of 35 immature children aged 5 to 10 years who suffered from bilateral recurrent patellar dislocation associated with abnormal patella morphology were enrolled in this study. The knees with the most frequent dislocations (treated with medial patellar retinacular plasty) were selected as the study group (SG), and those undergoing conservative treatment for the contralateral knee were selected as the control group (CG). Computed tomography (CT) scans were performed on all children preoperatively and at the last follow-up to evaluate morphological characteristics of the patella. Results All the radiological parameters of the patella showed no significant difference between the two groups preoperatively. At the last follow-up for CT scans, no significant differences were found for the relative patellar width (SG, 54.61%; CG, 52.87%; P = 0.086) and the relative patellar thickness (SG, 26.07%; CG, 25.02%; P = 0.243). The radiological parameters including Wiberg angle (SG, 136.25°; CG, 122.65°; P < 0.001), modified Wiberg index (SG, 1.23; CG, 2.65; P < 0.001), and lateral patellar facet angle (SG, 23.35°; CG, 15.26°; P < 0.001) showed statistical differences between the two groups. Conclusions The patellar morphology can be improved by early surgical correction in children with recurrent patellar dislocation. Therefore, early intervention is of great importance for children diagnosed with recurrent patellar dislocation.

scholarly journals Changes in Patellar Morphology Following Surgical Correction of Recurrent Patellar Dislocation in Children

2021 ◽  
Author(s):  
Weifeng Li ◽  
Qian Wang ◽  
Hui Li ◽  
shunyi wang
Keyword(s):  
Patellar Dislocation ◽  
Morphological Changes ◽  
Morphological Characteristics ◽  
Surgical Correction ◽  
Ct Scans ◽  
Control Group ◽  
Recurrent Patellar Dislocation ◽  
Radiological Parameters ◽  
Significant Difference

Abstract Background: The aim of this study was to evaluate the morphological changes of patella following surgical correction of recurrent patellar dislocation in children. Methods: 35 immature children aged 5 to 10 years who suffered from bilateral recurrent patellar dislocation associated with abnormal patella morphology. The knee had most frequently patellar dislocation, which was underwent medial patellar retinacular plasty, and defined as in the study group(SG). The contralateral knee was treated conservatively and defined as in the control group (CG). Computed tomography (CT) scans were performed on all children preoperatively and at the last follow-up to evaluate the patellar morphological characteristics. Results: All the radiological parameters of the patella, showed no significant difference between the two groups, Preoperatively. At the last follow-up for CT scans, no signifcant diferences were evaluable for the relative patellar width (SG, 54.61%; CG, 52.87%; p=0.086) and the relative patellar thickness (SG, 26.07% ; CG, 25.02%; p = 0.243). The radiological parameters including Wiberg-angle (SG, 136.25°; CG, 122.65°; p < 0.001), modified Wiberg-index (SG, 1.23; CG, 2.65 ; p < 0.001), and lateral patellar facet angle (SG, 23.35° ; CG, 15.26°; p < 0.001) showed statistical differences between the two groups. Conclusions: The morphology of the patella can be improved by early surgical correction in children with recurrent patellar dislocation. Early intervention for children with recurrent patellar dislocation is important.

The 3-in-1 Procedure for Recurrent Dislocation of the Patella in Skeletally Immature Children and Adolescents

2009 ◽  
Vol 37 (9) ◽  
pp. 1814-1820 ◽  
Author(s):  
Francesco Oliva ◽  
Mario Ronga ◽  
Umile Giuseppe Longo ◽  
Vittorino Testa ◽  
Giovanni Capasso ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Patellar Dislocation ◽  
Case Series ◽  
Skeletal Maturation ◽  
Isokinetic Strength ◽  
Skeletally Immature ◽  
Recurrent Patellar Dislocation ◽  
Level Of Evidence ◽  
The Mean

Background Recurrent patellar dislocations are common injuries in children and adolescents. The subjective and functional results of soft tissue surgical management in a population that was skeletally immature at the time of surgery have not been reported. Hypothesis The 3-in-1 procedure is an effective treatment for recurrent patellar dislocation in skeletally immature patients. Study Design Case series; Level of evidence, 4. Methods Twenty-five skeletally immature patients (age at operation, 13.5 ± 3.8 years) who were practicing sports and suffering from recurrent unilateral patellar dislocation were included in the study and followed until skeletal maturation. Clinical evaluation included the modified Cincinnati rating system and the Kujala score, anthropometry, plain radiography, and isokinetic dynamometry. Results The average follow-up was 3.8 years (range, 2.5-6 years). The mean modified Cincinnati score increased from 51.7 ± 12.6 preoperatively to 94.3 ± 10.8 (P < .02), while the mean Kujala scores increased from 52.4 ± 12.7 preoperatively to 93.8 ± 14.2 (P < .02). The Insall-Salvati index remained essentially unchanged, being 1.04 ± 0.2 preoperatively and 1.02 ± 0.3 at latest follow-up. Significant differences were found between the operated and the contralateral limb in the various isokinetic strength variables at all angular velocities measured at the latest follow-up (.05 < P < .0042). Conclusion The 3-in-1 procedure is a safe, reliable management option for recurrent patellar dislocation in skeletally immature patients. Side-to-side differences in isokinetic strength and in anthropometric indices persist despite subjective success of the procedure.

Surgical Treatment With Closing-Wedge Distal Femoral Osteotomy for Recurrent Patellar Dislocation With Genu Valgum

2018 ◽  
Vol 46 (7) ◽  
pp. 1632-1640 ◽  
Author(s):  
Kyung Wook Nha ◽  
Yoonwon Ha ◽  
Seungmin Oh ◽  
Vivek P. Nikumbha ◽  
Sae Kwang Kwon ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Patellar Dislocation ◽  
Femoral Osteotomy ◽  
Genu Valgum ◽  
Lateral Release ◽  
Trochlear Groove ◽  
Recurrent Patellar Dislocation ◽  
Distal Femoral Osteotomy ◽  
The Mean

Background: Closing-wedge distal femoral osteotomy (CWDFO)—combined with medial reefing and lateral release, if necessary— has been used to treat recurrent patellar dislocation (RPD) with genu valgum. Purpose: To evaluate the clinical and radiologic outcomes of surgical treatment with CWDFO for treatment of RPD with genu valgum. Study Design: Case series; Level of evidence, 4. Methods: Fourteen consecutive patients (23 knees) with RPD and genu valgum were treated with CWDFO. Patients with a minimum 2-year follow-up period were eligible for this study. Patients with prior failed surgery were also eligible. Radiographic evaluation was performed with mechanical femorotibial and lateral distal femoral angle. The radiographic parameters presenting patellar positions and pathologic abnormalities associated with RPD were evaluated. Chondral lesion changes in second-look arthroscopic examination were examined, and clinical outcomes (eg, occurrence of redislocation, range of motion, and clinical scores) were assessed pre- and postoperatively at a minimum of 2 years. Results: At a mean follow-up of 30.7 months (range, 25-62 months), the mean mechanical femorotibial and mechanical lateral distal femoral angles changed significantly from valgus 5° (range, 2°-11°) to varus 3° (2°-11°; P < .001) and from 83° (range, 78°-86°) to 89° (84°-92°; P < .001), respectively. The mean patellar congruence angle improved from 40° lateral (range, 20°-53° lateral) to 4° medial (23° medial to 21° lateral; P < .001), as did the lateral patellofemoral angle from 26° (range, 8°-62°) to 9° (0°-15°; P < .001). Computed tomography scans showed that the mean distance of patellar lateral shift decreased from 13.5 mm (range, 4-22 mm) to 2.0 mm (–4 to 5 mm; P < .001). The mean tibial tubercle to trochlear groove distance significantly decreased from 20.4 to 13.5 mm ( P < .001), while the Caton-Deschamps ratio did not change significantly after surgery ( P = .984). Chondral lesions of the patella and trochlear groove significantly improved or were maintained. None of the patients experienced subluxation or redislocation after surgery. Patellar instability symptoms also improved, as validated by radiographic and other clinical outcomes. Conclusion: CWDFO combined with medial reefing and lateral release successfully treated RPD with genu valgum for a minimum follow-up of 2 years, with improved patellar alignment and stability.

scholarly journals Preoperative Complete Patellofemoral Dislocation in Extension Predicts an Inferior Clinical Outcome After Medial Patellofemoral Ligament Reconstruction in Patients With Recurrent Patellar Dislocation

2020 ◽  
Vol 8 (7) ◽  
pp. 232596712093898
Author(s):  
ZhiJun Zhang ◽  
GuanYang Song ◽  
QianKun Ni ◽  
Tong Zheng ◽  
Yanwei Cao ◽  
...  
Keyword(s):  
Patellar Dislocation ◽  
Trochlear Dysplasia ◽  
Tibial Tubercle ◽  
Control Group ◽  
3 Dimensional ◽  
Patellar Maltracking ◽  
Patient Reported ◽  
The Mean ◽  
Redislocation Rate

Background: Habitual patellar dislocation in extension (HPD-E) is a distinctive subtype of recurrent patellar dislocation (RPD); HPD-E represents the most severe type of patellar maltracking in RPD. It has been reported that the presence of preoperative patellar maltracking is associated with a worse clinical outcome after medial patellofemoral ligament (MPFL) reconstruction (MPFL-R). Purpose: To describe the radiological characteristics of HPD-E and to compare clinical outcomes after MPFL-R among patients with and without preoperative HPD-E. Study Design: Cohort study; Level of evidence, 3. Methods: From January 2012 to December 2015, a total of 230 consecutive patients (246 knees) with RPD were treated with MPFL-R alone or combined with tibial tubercle osteotomy. Among them, 28 patients diagnosed with HPD-E by preoperative 3-dimensional computed tomography (CT; HPD-E group) were matched in a 1:1 fashion to 28 control participants who did not show HPD-E (control group). Routine radiography and CT were performed to evaluate patellar height, trochlear dysplasia, tibial tubercle–trochlear groove distance, and torsional deformities. The mean patellar laxity index and lateral patellar translation assessed with stress radiography were measured preoperatively and postoperatively to quantify MPFL laxity. At minimum 2-year follow-up, patient-reported outcomes (Kujala, Lysholm, and Tegner scores), patellar maltracking, and redislocation rates were compared between the HPD-E and control groups. Results: The radiological characteristics of the HPD-E group were as follows: 89% (25/28) of patients had severe trochlear dysplasia (Dejour type B or D), and the mean femoral anteversion angle was 35.5° ± 4.7°. At the final follow-up, the HPD-E group had a significantly lower Kujala score (76.2 vs 84.5, respectively; P = .001), Lysholm score (75.4 vs 86.6, respectively; P < .001), and Tegner score (4.1 vs 5.8, respectively; P = .021) compared with the control group. The postoperative patellar laxity index (43% vs 19%, respectively; P < .001) and redislocation rate (25% vs 0%, respectively; P = .01) were significantly higher in the HPD-E group than in the control group. Conclusion: Preoperative 3-dimensional CT is a reliable method of identfying patients with HPD-E. Treatment of HPD-E by MPFL-R alone or combined with tibial tubercle osteotomy resulted in a higher redislocation rate, more severe MPFL residual laxity, and lower patient-reported outcome scores compared with patients without HPD-E who underwent MPFL-R.

Isolated Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Dislocation

2009 ◽  
Vol 37 (9) ◽  
pp. 1735-1742 ◽  
Author(s):  
Mario Ronga ◽  
Francesco Oliva ◽  
Umile Giuseppe Longo ◽  
Vittorino Testa ◽  
Giovanni Capasso ◽  
...  
Keyword(s):  
Patellar Dislocation ◽  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Case Series ◽  
Predisposing Factors ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Recurrent Patellar Dislocation ◽  
Level Of Evidence ◽  
The Mean

Background Several medial patellofemoral ligament reconstruction procedures have been proposed to manage recurrent patellar dislocation. Hypothesis Reconstruction of the medial patellofemoral ligament using a hamstring graft with a 2 transverse patellar tunnels technique is an effective treatment for recurrent patellar dislocation in patients without any evident predisposing factors. Study Design Case series; Level of evidence, 4. Methods Twenty-eight patients with chronic patellar instability without any anatomic predisposing factors, experiencing recurrent unilateral patellar dislocation, were included in the study. Evaluation included the modified Cincinnati and the Kujala scores, anthropometry, plain radiography, and isokinetic dynamometry. Results The average follow-up was 3.1 years (range, 2.5-4 years). The mean modified Cincinnati score increased from 52 preoperatively to 89 (P = .001). The mean Kujala scores increased from 45 preoperatively to 83 (P = .03). The muscle volume of the thigh of the operated limb increased with time, but remained less well developed than the nonoperated limb (P = .04). The mean Insall-Salvati index was 1.1 (range, 0.9-1.2) preoperatively and remained within normal range (1.1 [range, 0.9 to 1.2]) (P = .07), at latest follow-up. Significant isokinetic strength differences were found between the operated and the contralateral limbs (.05 < P < .006), even at the latest follow-up. Three patients experienced a new patellar dislocation. Conclusion Medial patellofemoral ligament reconstruction using hamstring tendon passed through a double patellar transverse bony tunnel technique is a safe, reliable management option for recurrent patellar dislocation in patients without any predisposing anatomic factors.

Arthroscopic Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Dislocation: Short-term Clinical Results

2020 ◽  
Author(s):  
Yong Huang ◽  
Yuan Yang ◽  
Mingjin Zhong ◽  
Fan Su ◽  
Jian Xu ◽  
...  
Keyword(s):  
Patellar Dislocation ◽  
Medial Patellofemoral Ligament ◽  
Recurrent Dislocation ◽  
Clinical Results ◽  
Recurrent Patellar Dislocation ◽  
Patellar Tilt ◽  
Kujala Score ◽  
The Mean ◽  
Tegner Score

Abstract The present study aimed to introduce a novel technique to reconstruct medial patellofemoral ligament (MPFL) via arthroscopy for recurrent patellar dislocation. A retrospective review of a prospectively collected registry was undertaken. A total of 34 patients (35 knees) who underwent arthroscopic reconstruction of MPFL from December 2017 to August 2019 were identified. Kujala score, Tegner score, Lyscholm score, patellar tilt, and congruence angle were recorded preoperatively and postoperatively. The occurrences of patient satisfaction, complications, and recurrent dislocation were recorded. The cohort consisted of both genders equally, and the mean age was 21.0±7.8 years, the mean body mass index was 22.5±3.5, and the mean follow-up time was 21.8±5.6 months. The patellar tiltdecreased from 46.4±19.3° to 12.5±16.9° (P < 0.001), the congruence angle decreased from 46.4±19.3° to 12.5±16.9° (P < 0.001), Kujala score improved from 55.1±4 to 88.7±4.4 (P < 0.001); Tegner score improved from 1.3±0.4 to 3.7±1.1 (P < 0.001), and Lyscholm score improved from 55.5±3.9 to 89.1±4.8 (P < 0.001). Among them, 30 (88.2%) patients fully recovered to normal pain-free daily life, 24 patients (70.6%) returned to sports, 32 patients were satisfied with surgery, and no redislocations were encountered. MPFL reconstruction via arthroscopy improves the knee joint function in patients with recurrent patellar dislocation and is a safe and effective surgical treatment for recurrent patellar dislocation.

scholarly journals The Morphology of Patella changed significantly after Soft Tissue Correction for children with Recurrent Patella Dislocation

2020 ◽  
Author(s):  
Jinghui Niu ◽  
Qi Qi ◽  
Kuo Hao ◽  
Wei Lin ◽  
Kang Piao ◽  
...  
Keyword(s):  
Patellar Dislocation ◽  
Patella Dislocation ◽  
Transverse Diameter ◽  
Recurrent Patellar Dislocation ◽  
Unaffected Side ◽  
Femoral Trochlea ◽  
Affected Side ◽  
Wiberg Index ◽  
Patellar Morphology

Abstract Background: Although morphological improvement of femoral trochlea has been investigated in children with patellar dislocation after surgery, whether the patellar shape changed under the same condition is still unknown. The purpose of the study was to investigate the changes of patellar morphology in transverse plane following surgical correction of recurrent patella dislocation in children.Methods: A total of 22 patients with a mean age of 9.9 years (7 to 12) were included. All had unilateral recurrent patellar dislocation. The knees with recurrent patellar dislocation were treated with medial patellar retinaculum plasty and defined as the affected side. The contralateral knees with no symptom of patellar instability were considered as the unaffected side. All patients were treated between October 2014 and August 2018. Axial CT (Computed Tomography) scans were undertaken in all patients to assess the patella morphological characteristics on a particular axial image preoperatively and at the final follow-up.Results: There were not significant differences about patellar transverse diameter, thickness and Wiberg angle between affected side and unaffected side before surgery and at the last follow-up respectively ( The mean follow-up period: 28.0 ± 3.3 months). However, before surgery, the Wiberg-index in the affected side (0.74 ± 0.06) was significantly different from that in the unaffected side (0.64 ± 0.04). At the last follow-up, the Wiberg-index in the affected side (0.67 ± 0.05) and the unaffected side (0.65 ± 0.04) were not significantly different. Also, in the affected side, the Wiberg-index at the last follow-up was significantly lower than that before surgery (P < 0.05). The Wiberg-index in the unaffected side was not significantly different before surgery and at the last follow-up. Conclusion: The patellar morphology can change significantly after surgical procedures in children with patellar recurrent dislocation whose epiphysis is not closed.

scholarly journals Derotational Femoral Osteotomy for Treating Recurrent Patellar Dislocation in the Presence of Increased Femoral Anteversion: A Systematic Review

2021 ◽  
Vol 9 (11) ◽  
pp. 232596712110571
Author(s):  
ZhiJun Zhang ◽  
Yanwei Cao ◽  
Guanyang Song ◽  
Yue Li ◽  
Tong Zheng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Patellar Dislocation ◽  
Femoral Anteversion ◽  
Femoral Osteotomy ◽  
Cochrane Library ◽  
Recurrent Patellar Dislocation ◽  
Patient Reported ◽  
The Mean

Background: Studies on the clinical outcomes of derotational femoral osteotomy to treat recurrent patellar dislocation in the presence of increased femoral anteversion are limited. Purpose: To investigate the role of derotational femoral osteotomy in the treatment of recurrent patellar dislocation in the presence of increased femoral anteversion. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed according to the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses) by searching the Medline, Embase, Web of Science, and Cochrane Library databases through February 10, 2021. Included were studies of skeletally mature patients presenting with recurrent patellar dislocation and exhibiting increased femoral anteversion who subsequently underwent derotational femoral osteotomy. Methodological quality was assessed using the MINORS (Methodological Index for Nonrandomized Studies) score. The basic characteristics of each study were recorded and analyzed: characteristic information, radiological parameters, surgical techniques, patient-reported outcomes, and complications. Results: A total of 6 studies with 163 patients (170 knees) were included. Sample sizes ranged from 7 to 66 patients, and the patients were predominantly women (range, 79%-100%). The mean age and follow-up ranges were 18 to 28 years and 16 to 44 months, respectively. The mean femoral anteversion decreased significantly from 34° preoperatively to 12° postoperatively. In studies reporting pre- and postoperative outcomes, significant improvements were found in the Lysholm score (from 24.8 to 44.1), Kujala score (from 15.8 to 41.9), International Knee Documentation Committee score (from 11.0 to 28.0), and visual analog scale for pain (from 2.0 to 3.7). All studies reported postoperative complications, giving an overall reported complication rate of 4.7%, but no redislocations occurred during the follow-up period. Conclusion: For recurrent patellar dislocation in the presence of increased femoral anteversion, combination treatment with derotational femoral osteotomy led to favorable clinical outcomes with a low redislocation rate. However, there was no consensus among researchers on the indications for derotational femoral osteotomy in the treatment of recurrent patellar dislocation.

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