Several patient factors may yield unsatisfactory results after tibial tuberosity anteromedialization

Davide E. Bonasia

Patients undergoing tibial tuberosity anteromedialization may be predisposed to unsatisfactory outcomes and early failure if they are older, have increased femoral anteversion foot pronation and positive postoperative crepitus, according to results.

Using the WOMAC–Short-Form (WOMAC-SF) and Kujala scores, Davide E. Bonasia, MD, and colleagues radiographically and clinically evaluated 78 knees in 69 patients (74.4% were women) with patellofemoral chondral disease undergoing tibial tuberosity anteromedialization (TTA) with or without lateral release. Patients had a minimum 2-year follow-up. Researchers correlated the outcomes using multiple logistic regression. Skeletal maturity, age younger than 65 years, a lower than grade 3 Kellgren-Lawrence degeneration and isolated patellofemoral pain for 6 months or more despite nonoperative treatment were indications of TTA for chondral disease.

Results showed significant improvement in WOMAC-SF and Kujala scores after surgery. On average, researchers found patients graded their operated knee as approximately 7.2 points of 10 points, with 74.4% of patients stating they would undergo the surgery again.

Multiple regression model showed an association between a WOMAC-SF score of greater than 7 points and age older than 45 years, as well as increased femoral anteversion. Researchers also found an association between a Kujala score of less than 80 points with age older than 45 years and foot pronation. Positive postoperative patellofemoral crepitus was associated with patient satisfaction of less than 7 points. With dissatisfaction as an endpoint, researchers found Kaplan-Meier survivorship of 94%, 88% and 77% at 43 months, 77 months and 108 months, respectively. – by Casey Tingle

Disclosures: Bonasia reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.

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Source:

Rosso F, et al. Am J Sports Med. 2017;doi;10.1177/0363546517690387.