BACKGROUND: Surgical treatment of patellofemoral instability can successfully diminish episodes of subluxation and dislocation, as well as symptoms of pain and instability. HYPOTHESIS: Surgical treatment of lateral patellar instability in a strictly athletic population will facilitate return to sports. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: From 1999 to 2004, 41 Fulkerson osteotomies combined with an arthroscopic lateral release were performed in 34 athletes for patellofemoral instability. Three patients were lost to follow-up. All patients participated in sports at least 3 times per week in at least one sport for 4 months of the year. There were 4 male and 30 female patients; 7 patients underwent bilateral, staged procedures. There were 14 high school, 12 collegiate, and 8 recreational athletes. Results were obtained by an independent examiner. RESULTS: The mean age was 20.05 years (range, 14-54 years) with a mean follow-up of 46 months (range, 22-71 months). Patients averaged 1.3 dislocations before reconstruction (range, 0-6). The average Lysholm score was 91.8 (range, 67-100) at follow-up. The International Knee Documentation Committee (IKDC) scores were A (normal) in 27 knees, B (near normal) in 12, and C (abnormal) in 2. Seventeen patients had symptomatic hardware removed at an average of 8 months. There were 2 complications: one saphenous neuroma that resolved, and one recurrent dislocation in a patient later diagnosed with Ehlers-Danlos syndrome. CONCLUSION: This series is the largest to date documenting the successful treatment of patellofemoral instability in athletes with concomitant Fulkerson osteotomy and arthroscopic lateral release. Forty-nine percent of patients in our series required removal of screws from the osteotomy site.
BACKGROUND: Surgical treatment of patellofemoral instability can successfully diminish episodes of subluxation and dislocation, as well as symptoms of pain and instability. HYPOTHESIS: Surgical treatment of lateral patellar instability in a strictly athletic population will facilitate return to sports. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: From 1999 to 2004, 41 Fulkerson osteotomies combined with an arthroscopic lateral release were performed in 34 athletes for patellofemoral instability. Three patients were lost to follow-up. All patients participated in sports at least 3 times per week in at least one sport for 4 months of the year. There were 4 male and 30 female patients; 7 patients underwent bilateral, staged procedures. There were 14 high school, 12 collegiate, and 8 recreational athletes. Results were obtained by an independent examiner. RESULTS: The mean age was 20.05 years (range, 14-54 years) with a mean follow-up of 46 months (range, 22-71 months). Patients averaged 1.3 dislocations before reconstruction (range, 0-6). The average Lysholm score was 91.8 (range, 67-100) at follow-up. The International Knee Documentation Committee (IKDC) scores were A (normal) in 27 knees, B (near normal) in 12, and C (abnormal) in 2. Seventeen patients had symptomatic hardware removed at an average of 8 months. There were 2 complications: one saphenous neuroma that resolved, and one recurrent dislocation in a patient later diagnosed with Ehlers-Danlos syndrome. CONCLUSION: This series is the largest to date documenting the successful treatment of patellofemoral instability in athletes with concomitant Fulkerson osteotomy and arthroscopic lateral release. Forty-nine percent of patients in our series required removal of screws from the osteotomy site.
Authors: Saandeep Mani; Marcus S Kirkpatrick; Archana Saranathan; Laura G Smith; Andrew J Cosgarea; John J Elias Journal: Am J Sports Med Date: 2011-01-13 Impact factor: 6.202
Authors: Daniel K Schneider; Brian Grawe; Robert A Magnussen; Adrick Ceasar; Shital N Parikh; Eric J Wall; Angelo J Colosimo; Christopher C Kaeding; Gregory D Myer Journal: Am J Sports Med Date: 2016-02-12 Impact factor: 6.202
Authors: Avinesh Agarwalla; Joseph N Liu; Hao-Hua Wu; Irene L Kalbian; Grant H Garcia; Beth E Shubin Stein Journal: Cartilage Date: 2020-04-22 Impact factor: 3.117