Acta Orthop Traumatol Turc
Fulkerson osteotomy for the treatment of chronic patellofemoral malalignment
Abstract
Objectives: We evaluated the results of Fulkerson osteotomy in patients with chronic patellofemoral malalignment.
Methods: Fulkerson osteotomy (anteromedial tibial tubercle transfer) was performed in 21 knees of 18 patients (10 females, 8 males; mean age 28.6 years; range 21 to 42 years). The patellofemoral congruence angle, lateral patellofemoral angle, and patellofemoral index were measured pre- and postoperatively on tangential radiograms obtained at 45° knee flexion. Malalignment patterns were determined by computed tomography as lateral tilt (n=12), lateral patellar subluxation (n=4), and both (n=5). All the patients underwent arthroscopic examination preoperatively and all had severe osteoarthrosis in the patellar articular surfaces (Outerbridge type III-IV). The mean anteriorization was 10.5 mm (range 7 to 15 mm). The vastus medialis oblique muscle was advanced in seven knees. The patients were assessed according to the criteria of Fulkerson et al. pre- and postoperatively. The mean follow-up was 28 months (range 20 to 60 months).
Results: According to the criteria of Fulkerson et al., the results were excellent, very good, or good in 18 knees (85.7%), fair in two knees (9.5%), and poor in one knee (4.8%). Pain and instability scores showed significant improvement (p
Methods: Fulkerson osteotomy (anteromedial tibial tubercle transfer) was performed in 21 knees of 18 patients (10 females, 8 males; mean age 28.6 years; range 21 to 42 years). The patellofemoral congruence angle, lateral patellofemoral angle, and patellofemoral index were measured pre- and postoperatively on tangential radiograms obtained at 45° knee flexion. Malalignment patterns were determined by computed tomography as lateral tilt (n=12), lateral patellar subluxation (n=4), and both (n=5). All the patients underwent arthroscopic examination preoperatively and all had severe osteoarthrosis in the patellar articular surfaces (Outerbridge type III-IV). The mean anteriorization was 10.5 mm (range 7 to 15 mm). The vastus medialis oblique muscle was advanced in seven knees. The patients were assessed according to the criteria of Fulkerson et al. pre- and postoperatively. The mean follow-up was 28 months (range 20 to 60 months).
Results: According to the criteria of Fulkerson et al., the results were excellent, very good, or good in 18 knees (85.7%), fair in two knees (9.5%), and poor in one knee (4.8%). Pain and instability scores showed significant improvement (p
References
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