2025 ISAKOS Biennial Congress ePoster
Torsional Limb Deformities In Patients With Lateral Patellar Dislocation: An Expert Survey Of The International Patellofemoral Study Group.
Guido Wierer, MD, Sistrans, Tirol AUSTRIA
Danko Dan Milinkovic, MD, Berlin GERMANY
Gerd Seitlinger, MD, Salzburg AUSTRIA
Michael C. Liebensteiner, MD, PhD, Innsbruck, Tyrol AUSTRIA
William R. Post, MD, Morgantown, WV UNITED STATES
Philipp Wilhelm Winkler, MD, Assoc. Prof., Linz AUSTRIA
Research Unit for Orthopaedic Sports Medicine and Injury Prevention, Private University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, AUSTRIA
FDA Status Not Applicable
Summary
Torsional deformities of the lower limb are a clinically relevant topic in the management of patients with recurrent lateral patellar dislocation.
ePosters will be available shortly before Congress
Abstract
Purpose
To evaluate current knowledge and discover potential controversies in treating torsional deformities of the lower limb in patients with lateral patellar dislocation (LPD).
Methods
An online survey was distributed to all active International Patellofemoral Study Group (IPSG) members, representing an international sample of orthopedic surgeons with a specific interest and experience in patellofemoral joint disorders. The survey included 21 single- and multiple-choice questions and was distributed by email between 2022 and 2023.
Results
Thirty-five members (54%) completed the questionnaire. The responding experts conduct a hip-knee-ankle MRI or CT following first-time and recurrent patellar dislocation based on clinical examination (43% and 49%, respectively), routinely (6% and 23%, respectively), or not at all (51% and 29%, respectively). Two-thirds of the experts perform derotational osteotomies of the femur, and 37% perform derotational osteotomies of the tibia. Most of these surgeons (61% and 69%, respectively) perform less than five derotational osteotomies of the femur or tibia per year. The most important factors for performing rotational osteotomy are abnormal torsion, abnormal gait pattern, revision cases, and recurrent patellar instability. Most surgeons (65%) agree on a cutoff value of >30° of femoral ante-torsion and >35° of external tibial torsion to perform derotational osteotomy, but the preferred measurement techniques vary.
Conclusion
Torsional deformities of the lower limb are a clinically relevant topic in the management of patients with recurrent LPD. Although the caseload is low, most experts perform derotational osteotomies. Diagnostic and therapeutic algorithms overlap widely between surgeons, but the indication and cutoff values for performing derotational osteotomy must be further established.