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ISSN 2007-087X (Print)
Órgano Oficial de la Sociedad Mexicana de Ortopedia Pediátrica

2022, Number 1-3

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Rev Mex Ortop Ped 2022; 24 (1-3)

Radiographic evaluation of patella alta recurrence according to the fixation material in postoperative cerebral palsy patients with distal femoral extension osteotomy and patellar tendon advancement

Herrera PC, Arenas DAL, Barrón TEA, Gómez CJ, Hernández GC, Martínez VM

Language: Spanish
References: 14
Page: 24-29
PDF size: 223.19 Kb.


ABSTRACT

Introduction: Distal femoral deflexion osteotomy and patellar tendon advancement used as a surgical treatment for crouching gait with knee flexion contracture of 15 to 25 degrees which occurs in 85% of patients with cerebral palsy. During the natural history of the disease, recurrence of patella alta has been observed regardless of material type. Objective: Evaluate the patella alta recurrence by the different method of fixation. Material and methods: Observational, retrospective, analytical cohort study in diplegic, spastic patients, gross motor I-III, ages 12 to 18 years, and that Ethibond®, FiberWire® and ASIF wire were used as suture material in patellar advancemente, january 2015 to december 2019. Patella alta was evaluated by the Insall-Salvati index, the modified Insall-Salvati index by Grelsamer and Meadows, Catón-Deschamps method and Koshino-Sugimoto index. The measures were evaluated preoperatively, postoperative and after 24 months follow-up. Results: 157 knees were evaluated. The male gender was presented in 105 knees and female, 52 knees. Gross motor III was observed in 85% of cases. The average preoperative Insall-Salvati index was 1.4, in the immediate postoperative period: 0.5, and at 24 months postoperative: 0.6. Wire was used in 55 knees, Ethibond® in 53 knees, and FiberWire® in 49 knees. The patella alta recurrence was observed in five knees in the wire group, 14 knees in the Ethibond® group, and 12 knees in the FiberWire® group. Conclusions: The wire fixation method is associated with less recurrence of the patella alta in patients at 24 months of follow-up (OR: 0.1, IC 95%: 0.03-0.2, p = 0.000).


REFERENCES

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EVIDENCE LEVEL

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