2025 ISAKOS Biennial Congress ePoster
Distal Femoral Osteotomy for the Treatment of Chronic Patellofemoral Instability Improves Gait Patterns
Peter Rab, MD GERMANY
Romed Peter Vieider, MD, München GERMANY
Lorenz Fritsch, MD, Munich, Bavaria GERMANY
Matthias Cotic, MSc, Munich, Bavaria GERMANY
Florian B. Imhoff, MD, Priv.-Doz., Basel SWITZERLAND
Sebastian Siebenlist, MD, MHBA, Prof., Munich, Bavaria GERMANY
Andrea E. Achtnich, Assoc. Prof., Munich GERMANY
Maximilian Hinz, MD, Munich GERMANY
Department of Sports Orthopedics, TUM Klinikum Munich, Munich, Bavaria, GERMANY
FDA Status Cleared
Summary
This study reported a postoperative improvement of dynamic gait patterns for patients who underwent surgery for the treatment of recurrent PFI according to an individual risk factor analysis, including distal femoral osteotomy.
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Abstract
Purpose
The purpose of this study was to evaluate pre- to postoperative changes in clinical and functional outcomes as well as gait patterns in patients that underwent surgery for chronic patellofemoral instability (PFI).
Methods
Patients who underwent surgery for the treatment of recurrent PFI according to an individual risk factor analysis were included. Pre- and minimum 12 months postoperatively, patient-reported outcome measures (PROM; Kujala score, Lysholm score, Tegner Activity Scale [TAS] and Visual Analog Scale for pain) as well as gait (dynamic Q-angle) and function (dynamic valgus and dynamic Trendelenburg during single-leg squat) via videography were evaluated. Subgroup analysis was performed based on whether patients underwent concomitant distal femoral osteotomy (DFO) due to coronal and/or torsional malalignment or not.
Results
Twenty-three patients, of which (60.9%) patients underwent a concomitant DFO, were included (follow-up: 12.5 [12.1-13.0] months). All PROM improved significantly (p < 0.05). Overall, dynamic Q-angle (p = 0.016) and dynamic valgus (p = 0.041) were observed significantly less frequently postoperatively when to compared to preoperatively. Subgroup analysis showed that only the group that underwent DFO had a significant improvement of dynamic Q-angle (p = 0.041). Dynamic Trendelenburg did not improve (p > 0.05). Regression analysis showed that the presence of a postoperative dynamic Q-angle was associated with worse postoperative Kujala score (p = 0.042) and TAS (p = 0.049).
Conclusion
Patient-individualized surgery for PFI improved gait patterns and functional testing, especially in patients that also underwent DFO. The presence of dynamic Q-angle postoperatively was associated with significant worse functional outcome and sporting ability.