Varus, valgus alignment may be nonmodifiable risk factor for patellofemoral instability
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Key takeaways:
- Patients with patellofemoral instability had significantly different mechanical axis vs. those with ACL injury.
- A significantly higher proportion of patients with patellofemoral instability had valgus alignment.
SAN FRANCISCO — Results presented here showed varus or valgus alignment may be a nonmodifiable risk factor for patellofemoral instability in pediatric and adolescent patients.
Julia Retzky, MD, Daniel W. Green, MD, MS, FACS, and colleagues retrospectively reviewed data for patients aged 8 to 21 years who experienced an ACL injury or one or more patellar instability episodes between 2015 and 2022. Patients included in the study had preoperative EOS (EOS imaging) lower limb radiographs. Researchers compared these two groups to a control cohort of patients with scoliosis with a Cobb angle of less than 20° who had biplane EOS imaging.
Researchers sent all preoperative radiographs for EOS 3D reconstructions and received data acquisitions with a focus on mechanical axis measurements.
“We divided the mechanical axis as valgus if the mechanical axis was greater than 1°, varus if the mechanical axis was less than –1° and neutral if the mechanical axis lies between –1° and 1°,” Retzky said in her presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
Among the 197 patients who met final inclusion criteria, Retzky said patients in the ACL injury, patellofemoral instability and control groups had statistically significant differences with regard to mechanical axis. The patellofemoral group had a significantly different mechanical axis vs. the ACL and control groups, according to Retzky. She added there were no significant differences in mechanical axis between the ACL and control groups.
“Looking more specifically at each group, we found that there was a significantly higher proportion of patients in the patellofemoral instability group with valgus alignment compared to the ACL and the control cohorts,” Retzky said.
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Retzky J, et al. Paper 489. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Feb. 12-16, 2024; San Francisco.
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