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Related Concept Videos

Bones of the Lower Limb: Femur and Patella01:16

Bones of the Lower Limb: Femur and Patella

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The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
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Similar Outcomes but Significantly Different Donor Site Morbidity Profiles After Autograft Quadriceps and Bone-Patellar Tendon-Bone Anterior Cruciate Ligament Reconstruction.

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Podium Abstracts Presented at the 2025 Annual Meeting of the Arthroscopy Association of North America.

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Anterior Cruciate Ligament Transection and Synovial Fluid Lavage in a Rodent Model to Study Joint Inflammation and Posttraumatic Osteoarthritis
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Economic Decision Model for First-Time Traumatic Patellar Dislocations in Adolescents.

Benedict U Nwachukwu1, Conan So2, William W Schairer1

  • 1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA.

The American Journal of Sports Medicine
|May 3, 2017
PubMed
Summary
This summary is machine-generated.

Immediate surgery for adolescent patellar dislocations offers the highest quality-adjusted life years (QALYs) gains, proving cost-effective. Delayed surgery is also cost-effective, but immediate surgical intervention maximizes patient outcomes over a 10-year period.

Keywords:
costcost-utility analysismedial patellofemoral ligamentpatellar dislocationquality of life

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Area of Science:

  • Orthopedic surgery
  • Health economics
  • Adolescent medicine

Background:

  • Surgical management of traumatic patellar dislocations in adolescents reduces recurrence.
  • The cost and quality-of-life benefits of surgical versus nonoperative treatment remain unclear.

Purpose of the Study:

  • To compare the cost-utility of three adolescent patellar dislocation management strategies.
  • Strategies include: nonoperative treatment only, delayed surgery for recurrent cases, and immediate surgery.

Main Methods:

  • A 10-year state-transition Markov model was used for cost-utility analysis.
  • Health state utilities were gathered from 60 adolescents with patellar dislocations.
  • Costs included direct surgical and indirect productivity losses; effectiveness was measured in quality-adjusted life years (QALYs).

Main Results:

  • Immediate surgery yielded the highest QALYs (6.32) at $17,100, compared to delayed surgery ($10,500, 5.93 QALYs) and nonoperative care ($7300, 5.30 QALYs).
  • Delayed surgery had an ICER of $5100/QALY vs. nonoperative care; immediate surgery had an ICER of $17,000/QALY vs. delayed surgery.
  • Model sensitivity showed delayed surgery preferred if nonoperative return to activity exceeds 47.5% or surgical return falls below 51%.

Conclusions:

  • Both immediate and delayed surgical treatments are cost-effective for adolescent patellar dislocations.
  • Immediate surgery maximizes QALY gains within a 10-year timeframe.
  • Findings inform clinical guidelines and policy for adolescent patellar dislocation management.