Diaphyseal Femoral Derotator Osteotomy for Patellofemoral Realignment: Indication, Technique and Results
DOI:
https://doi.org/10.63403/re.v33i2.478Keywords:
Osteotomy, Derotator, Diaphysary, PatellofemoralAbstract
Introduction: the increases in femoral anteversion affects the biomechanics of the patellofemoral joint, which can generate pain and/or instability in the latter with lesions of different magnitude.
Objectives: the primary objective of the following study was to analyze the functional outcomes and complications in a consecutive series of patients who underwent a femoral shaft osteotomy after failed conservative treatment.
Material and methods: the results obtained in a series of 21 patients (23 surgeries), during the period between 2018 and 2025 were retrospectively analyzed. Inclusion criteria: patellofemoral pain and/or instability, failure of conservative treatment, closed physis, absence of degenerative sequelae and increased femoral tomographic anteversion greater than 25 degrees. The Kujala functional score, radiological assessment and pre- and postoperative computed tomography were used.
Results: a population of 18 women and 5 men was studied. The median age was 23 years (16-42). The median preoperative anteversion was 34° (IQR 32-38°), decreasing to 11.5° (IQR 8.75-14.25°) postoperatively (p=0.03). The median preoperative Kujala score was 48 points (IIC 43-55), and postoperative was 86 points (IIC 82-92) (p<0.001). Twenty-one osteotomies were consolidated at 3 months, 1 case suffered material breakage due to fatigue and 1 patient presented with pseudoarthrosis. There were no infectious or thromboembolic complications in the series.
Conclusion: femur derotator diaphyseal osteotomy with blocked plaque osteosynthesis was effective in correcting the increase in femoral anteversion and improving symptoms of patellofemoral pain and/or instability.
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