Tibial Tuberosity Anteromedialization for Patellofemoral Chondral Disease: Prognostic Factors

Rosso, Federica; Rossi, Roberto; Governale, Giorgio; Marmotti, A.; Cherubini, Valeria; Cottino, Umberto; Bonasia, Davide Edoardo

doi:10.1177/0363546517690387

Cited by 19 publications

(37 citation statements)

References 34 publications

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Section: Discussionmentioning

confidence: 99%

“…35,54 7.14 89.29 Progressive weightbearing, as tolerated, with a knee brace locked in full extension does not excessively load the patellofemoral joint and is safe if no associated osteotomy is performed. 35,55,77 0.00 100.00 a ACI, autologous chondrocyte implantation; OCA, osteochondral allograft transplantation.…”

Section: Graft and Surgical Technique Considerationsmentioning

confidence: 99%

“…13,37,63 Notably, progressive weightbearing as tolerated with a knee brace locked in full extension does not excessively load the patellofemoral joint and is therefore considered safe if no associated osteotomy is performed. 35,55,77 This expert consensus statement fulfills established criteria for the reporting of Delphi studies 22 using a validated number of experts. 1 The 100% response rate across all 3 survey rounds highlights the commitment of these experts to establish a consensus on the management of patellofemoral chondral injuries.…”

Section: Rehabilitationmentioning

confidence: 99%

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An Expert Consensus Statement on the Management of Large Chondral and Osteochondral Defects in the Patellofemoral Joint

Chahla

Hinckel

Yanke

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Cartilage lesions of the patellofemoral joint constitute a frequent abnormality. Patellofemoral conditions are challenging to treat because of complex biomechanics and morphology. Purpose: To develop a consensus statement on the functional anatomy, indications, donor graft considerations, surgical treatment, and rehabilitation for the management of large chondral and osteochondral defects in the patellofemoral joint using a modified Delphi technique. Study Design: Consensus statement. Methods: A working group of 4 persons generated a list of statements related to the functional anatomy, indications, donor graft considerations, surgical treatment, and rehabilitation for the management of large chondral and osteochondral defects in the patellofemoral joint to form the basis of an initial survey for rating by a group of experts. The Metrics of Osteochondral Allografts (MOCA) expert group (composed of 28 high-volume cartilage experts) was surveyed on 3 occasions to establish a consensus on the statements. In addition to assessing agreement for each included statement, experts were invited to propose additional statements for inclusion or to suggest modifications of existing statements with each round. Predefined criteria were used to refine statement lists after each survey round. Statements reaching a consensus in round 3 were included within the final consensus document. Results: A total of 28 experts (100% response rate) completed 3 rounds of surveys. After 3 rounds, 36 statements achieved a consensus, with over 75% agreement and less than 20% disagreement. A consensus was reached in 100.00% of the statements relating to functional anatomy of the patellofemoral joint, 88.24% relating to surgical indications, 100.00% relating to surgical technical aspects, and 100.00% relating to rehabilitation, with an overall consensus of 95.5%. Conclusion: This study established a strong expert consensus document relating to the functional anatomy, surgical indications, donor graft considerations for osteochondral allografts, surgical technical aspects, and rehabilitation concepts for the management of large chondral and osteochondral defects in the patellofemoral joint. Further research is required to clinically validate the established consensus statements and better understand the precise indications for surgery as well as which techniques and graft processing/preparation methods should be used based on patient- and lesion-specific factors.

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Section: Discussionmentioning

confidence: 99%

Section: Graft and Surgical Technique Considerationsmentioning

confidence: 99%

Section: Rehabilitationmentioning

confidence: 99%

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An Expert Consensus Statement on the Management of Large Chondral and Osteochondral Defects in the Patellofemoral Joint

Chahla

Hinckel

Yanke

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…The TT-TG should be normalized to a target goal of less than 10 to 12 mm, whereas a 60° cut is commonly used by the senior author to achieve offloading of lateral and distally based patellar lesions while avoiding overmedialization. 19 , 20 Maintaining optimal patellofemoral biomechanics is essential to protect the biologic microenvironment of the osteochondral allograft, both to enhance incorporation and reduce adjacent articular disease progression.…”

Section: Discussionmentioning

confidence: 99%

Multiple Osteochondral Allograft Transplantation with Concomitant Tibial Tubercle Osteotomy for Multifocal Chondral Disease of the Knee

Cotter

Waterman

Kelly

et al. 2017

Arthroscopy Techniques

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Symptomatic patellofemoral chondral lesions are a challenging clinical entity, as these defects may result from persistent lateral patellar maltracking or repetitive microtrauma. Anteromedializing tibial tubercle osteotomy has been shown to be an effective strategy for primary and adjunctive treatment of focal or diffuse patellofemoral disease to improve the biomechanical loading environment. Similarly, osteochondral allograft transplantation has proven efficacy in physiologically young, high-demand patients with condylar or patellofemoral lesions, particularly without early arthritic progression. The authors present the surgical management of a young athlete with symptomatic tricompartmental focal chondral defects with fresh osteochondral allograft transplantation and anteromedializing tibial tubercle osteotomy.

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“…Furthermore, it is well known that PF malalignment and chondral disease is a multifactorial pathology, and different factors, such as patellar and trochlear morphology, may play a role affecting the outcomes of TTO alone in these patients. However, few studies evaluated factors related to outcomes in TTOs for PF chondral disease, but no association with patellar or trochlear morphology was recognized [7][8][9][10] .…”

Section: What Are the New Findings?mentioning

confidence: 99%

Tibial tubercle osteotomy for patellofemoral malalignment and chondral disease provided good outcomes: A systematic review

Rosso¹,

Rossi²,

Cottino³

et al. 2022

Journal of ISAKOS

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Tibial Tuberosity Anteromedialization for Patellofemoral Chondral Disease: Prognostic Factors

Cited by 19 publications

References 34 publications

An Expert Consensus Statement on the Management of Large Chondral and Osteochondral Defects in the Patellofemoral Joint

An Expert Consensus Statement on the Management of Large Chondral and Osteochondral Defects in the Patellofemoral Joint

Multiple Osteochondral Allograft Transplantation with Concomitant Tibial Tubercle Osteotomy for Multifocal Chondral Disease of the Knee

Tibial tubercle osteotomy for patellofemoral malalignment and chondral disease provided good outcomes: A systematic review

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