title: Prevalence of osteoarthritis and clinical results after the Elmslie-Trillat procedure: a retrospective long-term follow-up.
abstract: OBJECTIVE
  Tibial tuberosity medialisation may be followed by osteoarthritis in the long term due to increased patellofemoral contact pressure and altered knee joint kinematics. We aimed to (1) systematically assess the grades of tibiofemoral and patellofemoral osteoarthritis ten to 30 years after the Elmslie-Trillat procedure and (2) to evaluate long-term knee function and activities of daily living.
  
  
  METHODS
  A total of 26 patients (30 knees) were re-evaluated at a minimum follow-up of 12.3 years (mean 20.9 ± 4.1 years). Osteoarthritis was graded according to Kellgren and Lawrence (K/L) and Sperner. All patients were clinically evaluated using the Knee Society Score (KSS) and Knee injury and Osteoarthritis Outcome Score (KOOS). Radiographic data were compared to an age-, sex- and body mass index-matched control group of healthy patients.
  
  
  RESULTS
  Radiographic evaluation revealed seven cases (23.3%) with advanced osteoarthritis (K/L and Sperner grades 3 and 4). However, the observed differences from the matched cohort were not statistically significant (P = 0.189). A positive correlation was found between the age at index procedure and tibiofemoral osteoarthritis at follow-up (P = 0.013). Patient satisfaction was relatively high, showing a mean KSS of 89.9 (knee score) and 94.8 (function score), and a mean KOOS of 78.7. However, we noted four cases of frequent patellar re-dislocations and three total knee arthroplasties.
  
  
  CONCLUSIONS
  The Elmslie-Trillat procedure was associated with several cases of advanced tibiofemoral and patellofemoral osteoarthritis in the long term, especially if the procedure was performed late. Clinical results were still good to excellent in the majority of patients despite some observed cases of re-dislocations and decreased ability to perform sports.
authors.affiliation: Department of Pediatric Orthopedics, Deformity Correction and Adult Foot and Ankle Surgery, Orthopedic Hospital Speising, Speisingerstrasse 109, 1130, Vienna, Austria, sebastian.farr@oss.at.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Farr
authors.forename: Dominique
authors.initials: D
authors.lastname: Huyer
authors.forename: Patrick
authors.initials: P
authors.lastname: Sadoghi
authors.forename: Martin
authors.initials: M
authors.lastname: Kaipel
authors.forename: Franz
authors.initials: F
authors.lastname: Grill
authors.forename: Rudolf
authors.initials: R
authors.lastname: Ganger
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D017760:Bone Malalignment / Q000517:prevention & control*; D016022:Case-Control Studies; D005260:Female; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects*; D020370:Osteoarthritis, Knee / Q000209:etiology*; D031222:Patellar Dislocation / Q000601:surgery*; D015995:Prevalence; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome
references.citation: Am J Sports Med. 2004 Jul-Aug;32(5):1114-21
references.pmid: 15262631
references.citation: Rev Chir Orthop Reparatrice Appar Mot. 1964 Nov-Dec;50:813-24
references.pmid: 14256559
references.citation: J Orthop Surg (Hong Kong). 2005 Dec;13(3):280-4
references.pmid: 16365492
references.citation: Arthroscopy. 2008 Jan;24(1):77-81
references.pmid: 18182206
references.citation: Aktuelle Traumatol. 1990 Feb;20(1):24-8
references.pmid: 1969691
references.citation: Clin Orthop Relat Res. 1989 Nov;(248):13-4
references.pmid: 2805470
references.citation: Int Orthop. 2012 Dec;36(12):2447-56
references.pmid: 23052278
references.citation: World J Surg. 2008 Jun;32(6):952
references.pmid: 18401640
references.citation: Am J Sports Med. 2011 May;39(5):1024-31
references.pmid: 21233407
references.citation: Am J Sports Med. 2005 Aug;33(8):1220-3
references.pmid: 16000665
references.citation: Knee Surg Sports Traumatol Arthrosc. 2011 Feb;19(2):230-5
references.pmid: 20927505
references.citation: Knee. 2006 Dec;13(6):464-8
references.pmid: 17011193
references.citation: BMC Musculoskelet Disord. 2011 Feb 18;12:48
references.pmid: 21329530
references.citation: J Bone Joint Surg Br. 2002 Aug;84(6):861-4
references.pmid: 12211679
references.citation: Am J Sports Med. 2007 Nov;35(11):1851-8
references.pmid: 17724092
references.citation: Int Orthop. 2012 Sep;36(9):1819-25
references.pmid: 22552428
references.citation: Ann Rheum Dis. 1957 Dec;16(4):494-502
references.pmid: 13498604
references.citation: Emerg Radiol. 2013 Jan;20(1):11-23
references.pmid: 22941569
references.citation: J Orthop Sports Phys Ther. 1998 Aug;28(2):88-96
references.pmid: 9699158
references.citation: Int Orthop. 2010 Feb;34(2):297-303
references.pmid: 19998034
references.citation: Knee Surg Sports Traumatol Arthrosc. 2011 Jun;19(6):988-98
references.pmid: 21234544
references.citation: Am J Sports Med. 2001 Jul-Aug;29(4):403-9
references.pmid: 11476376
references.citation: Int Orthop. 2010 Feb;34(2):305-9
references.pmid: 20066411
references.citation: Knee Surg Sports Traumatol Arthrosc. 2012 Oct;20(10):2054-61
references.pmid: 22134408
references.citation: Unfallchirurg. 1999 Sep;102(9):700-7
references.pmid: 10506361
references.citation: Orthopade. 1998 Mar;27(3):197-205
references.pmid: 9585929
references.citation: Eur Radiol. 2012 Nov;22(11):2347-56
references.pmid: 22645041