Very low dislocation rate and good clinical outcome after Bereiter trochleoplasty and additional procedures following the Copenhagen patella–femoral instability algorithm: One- and two-years outcomes from a consecutive cohort of 368 cases

IF 5 2区医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-03-25 DOI:10.1002/ksa.12663

Christian Dippmann, Volkert Siersma, Simone Rechter, Kristoffer W. Barfod, Peter Lavard

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Abstract

Purpose

Patello–femoral instability (PFI) is often caused by predisposing factors, with trochlea dysplasia (TD) as the most prominent. Untreated patellar instability leads to impaired function and an increased risk of patellofemoral osteoarthritis. Since 2009 patients with PFI have been treated according to the Copenhagen PFI algorithm, where underlying osseous predisposing factors are addressed. The aim of this study was to report the two-year outcome after Bereiter trochleoplasty (TP) for high grade TD in a cohort of 368 consecutive patients treated according to the Copenhagen PFI algorithm from 2011 to 2021.

Methods

This was a register study evaluating a consecutive cohort of patients with high grade TD undergoing Bereiter trochleoplasty and additional procedures following the Copenhagen PFI algorithm. Outcomes were the Kujala score, the Knee Osteoarthritis Outcome Score (KOOS) and the Lysholm score collected preoperatively and after 1 and 2 years.

Results

From January 2011 to September 2021, 368 Bereiter TPs were performed on 346 patients (99 males, 225 females and 44 bilateral surgeries). Four knees (1.1%) experienced a re-dislocation. There were statistically significant (p < 0.0001) and clinically relevant improvements in all patients reported outcome measure (PROM)-scores 1 and 2 years after surgery. Over 2 years Kujala score improved mean (95% confidence interval) 18.7 (16.5–20.9), KOOS QoL 31.0 (28.0–34.0) and Lysholm score 20.0 (17.1–22.9).

Conclusions

Patients with high grade TD treated with Bereiter TP and additional procedures according to the Copenhagen PFI algorithm showed low re-dislocation rate and statistically significant and clinically relevant improvement in patient reported outcome 1 and 2 years after treatment.

Level of Evidence

Level II.

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在哥本哈根髌骨-股骨不稳定算法后，经Bereiter滑车成形术和其他手术后脱位率极低，临床效果良好：来自368例连续队列的1年和2年结果。

目的：髌股不稳定（PFI）常由易感因素引起，其中滑车发育不良（TD）最为突出。未经治疗的髌骨不稳定导致功能受损和髌骨股骨骨关节炎的风险增加。自2009年以来，PFI患者已根据哥本哈根PFI算法进行治疗，其中潜在的骨骼易感性因素得到解决。本研究的目的是报告2011年至2021年368例连续接受哥本哈根PFI算法治疗的高级别TD患者的Bereiter滑车成形术（TP）后两年的结果。方法：这是一项登记研究，评估了一组连续的高级别TD患者，他们接受了Bereiter滑车成形术和哥本哈根PFI算法后的其他手术。结果为术前及术后1年和2年的Kujala评分、膝关节骨性关节炎预后评分（kos）和Lysholm评分。结果：2011年1月至2021年9月，共346例患者（男99例，女225例，双侧44例）行368例Bereiter TPs手术。4个膝关节（1.1%）再次脱位。结论：根据哥本哈根PFI算法，接受Bereiter TP和附加手术治疗的高级别TD患者在治疗1年和2年后的再脱位率低，患者报告的预后有统计学意义和临床相关的改善。证据等级：二级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).