Ömer Naci ERGİN, Mehmet AŞIK, Ömer Faruk TAŞER

PATELLOFEMORAL DİZİLİM BOZUKLUĞUNDA TİBİAL TÜBERKÜL ANTEROMEDİALİZASYON (FULKERSON) CERRAHİSİNİN ORTA DÖNEM SONUÇLARI

Amaç: Patellofemoral dizilim bozukluğu instabilite, diz önü ağrısı, kondropati ve artroz için bilinen bir risk faktörüdür. Tibial tüberkülün lateral yerleşimli olduğu, ağrı ve/veya instabilite şikayeti olan patellofemoral dizilim bozukluğu tibial tüberkül osteotomisi ile etkin bir şekilde tedavi edilebilir. Gereç ve Yöntem: Biz çalışmamızda patellofemoral dizilim bozukluğu olup kliniğimizde Fulkerson osteotomisi yapılmış olan 45 Hastanın toplam 50 dizinin uzun dönem sonuçlarını sunmaktayız. Ortalama takip zamanı 116,9 aydır (60-204). Bulgular: Bizim kohortumuzda tüm radyolojik parametrelerde preoperatif değerlere göre anlamlı gelişme görülmüştür. Hastalarımızın çeşitli fonksiyonel ve ağrı skorlamalarına göre yaşam kaliteleri postoperatif anlamlı olarak artmıştır. Sonuç: Sonuç olarak, Fukerson osteotomisi patellofemoral dizilim bozukluğu zemininde lateral patellar instabilite ve/veya patellofemoral kondroz/artrozu olan hastalarda tedavide başarılı bir yöntemdir. Dikkatli hasta seçiminin sonucu etkileyen en önemli faktör olduğuna inanıyoruz.

Anahtar Kelimeler:

Patellofemoral dizilim bozukluğu, Tibial tüberkül anteromedializasyonu, Fulkerson osteotomisi

MIDTERM OUTCOMES OF TIBIAL TUBERCLE ANTEROMEDIALISATION (FULKERSON PROCEDURE) FOR PATELLOFEMORAL MALALIGNMENT

Objective: Patellofemoral malalignment is a known risk factor for instability, anterior knee pain, chondropathy and arthrosis. Patellofemoral malaligment with a laterally positioned tibial tubercle that results in symptoms of pain and/or instability can be effectively managed with a tibial tubercle osteotomy. Material and Method: We present long term results of 50 knees of 45 patients with patellofemoral malalignment treated with Fulkerson osteotomy at our institution. Results: The mean follow-up time was 116,9 months (60-204). Significant improvement was observed at all of the radiographic parameters when compared with the preoperative values of our cohort. We found that patients’ postoperative quality of life increased significantly according to various pain and functional scales. Conclusion: In conclusion, Fulkerson osteotomy is successful in the treatment of patients with lateral patellar instability and/ or patellofemoral chondrosis/artrosis owing to patellofemoral malalignment. We believe that careful patient selection is the most important factor determining the overall outcome.

Keywords:

Patellofemoral malalignment, Tibial tubercle anteromedialisation, Fulkerson osteotomy,

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