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Patient-Reported Outcomes After a Modified Albee Procedure.

Patrick J Bevan1, Lutul D Farrow1, Jared Warren1

  • 1Cleveland Clinic Orthopaedic and Rheumatologic Institute, Cleveland, Ohio, USA.

Orthopaedic Journal of Sports Medicine
|November 25, 2021
PubMed
Summary

The modified Albee osteotomy shows promise in preventing patellar dislocations for patients with trochlear dysplasia. While patient-reported outcomes suggest effectiveness, further research is needed due to incomplete follow-up data.

Keywords:
Albee osteotomyPROMpatellar dislocationpatellar instabilitytrochlear dysplasiatrochlear osteotomy

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Area of Science:

  • Orthopedic surgery
  • Knee biomechanics
  • Patellofemoral joint instability

Background:

  • Trochlear dysplasia (TD) is a known risk factor for patellofemoral instability.
  • The modified Albee osteotomy aims to correct TD by elevating the lateral trochlear wall to prevent dislocations.
  • Limited outcome data exists for this procedure, leaving patient-reported outcome measures (PROMs) largely unknown.

Purpose of the Study:

  • To determine PROM scores (Kujala Anterior Knee Pain Scale, International Knee Documentation Committee, Activity Rating System, Visual Analog Scale for pain) after modified Albee osteotomy.
  • To test the hypothesis that patients achieve acceptable pain and function at mid- to long-term follow-up.

Main Methods:

  • A case series (Level of evidence, 4) involving 46 patients (49 knees) who underwent the modified Albee procedure between 1999 and 2017.
  • Patients completed AKPS, IKDC, ARS, and VAS pain questionnaires; demographic data was collected via chart review.
  • Frequencies and means/standard deviations were calculated for demographic and PROM data.

Main Results:

  • Sixty-one percent (28 patients, 30 knees) completed PROMs at a minimum follow-up of 82 months.
  • Mean scores were: AKPS 78.5 ± 18.2, IKDC 61.2 ± 11.4, ARS 5.2 ± 5.3, VAS pain 24.4 ± 28.7.
  • Only one patient reported a subsequent patellofemoral dislocation, which was an isolated event.

Conclusions:

  • The modified Albee trochlear osteotomy may be a successful adjunct procedure for preventing recurrent patellar dislocations in mild TD.
  • Further investigation is warranted due to a significant loss to follow-up (one-third of scores) and the lack of baseline function data.
  • This procedure warrants further study for managing difficult cases of patellofemoral instability in select patients.