The Ali Krogius procedure for treatment of patellofemoral instability should be regarded as obsolete even in skeletally immature patients
Abstract Background Several interventions are established for treating patellofemoral instability in adults. Fewer exist for pediatric patients without damaging the epiphysis. The Ali Krogius (AK) method is currently still being used. Most studies are not current and report varying results in small...
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-022-05200-4 |
| _version_ | 1818646577274683392 |
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| author | Yannic Bangert Felix Mittelstrass Johannes Weisshorn Sébastien Hagmann Alexander Barié Ayham Jaber |
| author_facet | Yannic Bangert Felix Mittelstrass Johannes Weisshorn Sébastien Hagmann Alexander Barié Ayham Jaber |
| author_sort | Yannic Bangert |
| collection | DOAJ |
| description | Abstract Background Several interventions are established for treating patellofemoral instability in adults. Fewer exist for pediatric patients without damaging the epiphysis. The Ali Krogius (AK) method is currently still being used. Most studies are not current and report varying results in small patient population. The aim of this study is to determine the long-term results of the AK method. Methods In this monocentric, retrospective study design, 33 knees in 33 patients who received the AK procedure for recurrent patellar dislocation were assessed. The average age was 20.8 years (range 6–40). The following functional scores were assessed: Kujala Score, Lysholm Score and Tegner Score. Subgroup analysis was done for patients ≤16 years of age. Available preoperative imaging was assessed for known risk factors. Results After an average follow-up of 7.8 years (Range 59–145 months), a total of 8 (24%) knees suffered a redislocation postoperatively. Seven of the eight dislocations occurred in patients ≤ 16 years of age. One knee (3%) was revised due to persistent pain. The median score was 86 points for the Kujala score and 90 for the Lysholm score. The median in the Tegner score was level 6. Clinically, the patellar glide was lateralized in 7 knees (21%) and an apprehension sign was triggered in 8 knees (24%). Conclusions Including the present study, the existing literature indicates a redislocation rate between 24 and 41% following AK. It should thus be regarded as obsolete even though it protects the epiphysis. Surgical interventions such as medial patellofemoral ligament reconstruction with femoral drilling distal to the epiphysis should be preferred. Trial registration Retrospectively registered: S-302/2016. Level of evidence III |
| first_indexed | 2024-12-17T00:48:51Z |
| format | Article |
| id | doaj.art-51500c3e07134a909418bafb10a756f2 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-17T00:48:51Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-51500c3e07134a909418bafb10a756f22022-12-21T22:09:49ZengBMCBMC Musculoskeletal Disorders1471-24742022-03-012311810.1186/s12891-022-05200-4The Ali Krogius procedure for treatment of patellofemoral instability should be regarded as obsolete even in skeletally immature patientsYannic Bangert0Felix Mittelstrass1Johannes Weisshorn2Sébastien Hagmann3Alexander Barié4Ayham Jaber5Department of Orthopedics, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University HospitalDepartment of Diagnostic and interventional Radiology, Aachen University HospitalDepartment of Orthopedics, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University HospitalDepartment of Orthopedics, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University HospitalCenter for Joint Surgery and Sport Injuries, Sportopaedie Heidelberg, Clinic St. Elisabeth HeidelbergDepartment of Orthopedics, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University HospitalAbstract Background Several interventions are established for treating patellofemoral instability in adults. Fewer exist for pediatric patients without damaging the epiphysis. The Ali Krogius (AK) method is currently still being used. Most studies are not current and report varying results in small patient population. The aim of this study is to determine the long-term results of the AK method. Methods In this monocentric, retrospective study design, 33 knees in 33 patients who received the AK procedure for recurrent patellar dislocation were assessed. The average age was 20.8 years (range 6–40). The following functional scores were assessed: Kujala Score, Lysholm Score and Tegner Score. Subgroup analysis was done for patients ≤16 years of age. Available preoperative imaging was assessed for known risk factors. Results After an average follow-up of 7.8 years (Range 59–145 months), a total of 8 (24%) knees suffered a redislocation postoperatively. Seven of the eight dislocations occurred in patients ≤ 16 years of age. One knee (3%) was revised due to persistent pain. The median score was 86 points for the Kujala score and 90 for the Lysholm score. The median in the Tegner score was level 6. Clinically, the patellar glide was lateralized in 7 knees (21%) and an apprehension sign was triggered in 8 knees (24%). Conclusions Including the present study, the existing literature indicates a redislocation rate between 24 and 41% following AK. It should thus be regarded as obsolete even though it protects the epiphysis. Surgical interventions such as medial patellofemoral ligament reconstruction with femoral drilling distal to the epiphysis should be preferred. Trial registration Retrospectively registered: S-302/2016. Level of evidence IIIhttps://doi.org/10.1186/s12891-022-05200-4Ali krogiusPatellar instabilityPediatricpatellaKneePatellar dislocation |
| spellingShingle | Yannic Bangert Felix Mittelstrass Johannes Weisshorn Sébastien Hagmann Alexander Barié Ayham Jaber The Ali Krogius procedure for treatment of patellofemoral instability should be regarded as obsolete even in skeletally immature patients BMC Musculoskeletal Disorders Ali krogius Patellar instability Pediatric patella Knee Patellar dislocation |
| title | The Ali Krogius procedure for treatment of patellofemoral instability should be regarded as obsolete even in skeletally immature patients |
| title_full | The Ali Krogius procedure for treatment of patellofemoral instability should be regarded as obsolete even in skeletally immature patients |
| title_fullStr | The Ali Krogius procedure for treatment of patellofemoral instability should be regarded as obsolete even in skeletally immature patients |
| title_full_unstemmed | The Ali Krogius procedure for treatment of patellofemoral instability should be regarded as obsolete even in skeletally immature patients |
| title_short | The Ali Krogius procedure for treatment of patellofemoral instability should be regarded as obsolete even in skeletally immature patients |
| title_sort | ali krogius procedure for treatment of patellofemoral instability should be regarded as obsolete even in skeletally immature patients |
| topic | Ali krogius Patellar instability Pediatric patella Knee Patellar dislocation |
| url | https://doi.org/10.1186/s12891-022-05200-4 |
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