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Binomial theory applied to the creation of a treatment algorithm for patellofemoral pathology
Pablo Agustín Ramos Guarderas1, Gonzalo Fernando Arteaga Guerrero2, Medardo Javier Vargas Morante3
1Orthopedics and Traumatology, Arthroscopy, Hip and Knee Joint Replacement, Arthros Clinic, Quito, Ecuador.
Abstract:
The annual prevalence of patellofemoral pathology in the general population is 22.7%, and in adolescents, it is 28.9%. Diagnosing this pathology is complex and requires a proper clinical examination and complementary imaging studies for adequate treatment. This study aims to clarify, simplify, and present a diagnostic and treatment algorithm based on casuistry using binomial theory.
Materials And Methods:
A retrospective study included 100 patients, 70% female, with an average age of 31, diagnosed with patellofemoral pathology, treated with different therapeutic options described in the literature, and followed up for 12 months, evaluated using the Lysholm scale.
Results:
Among the surgically treated patients, 75% scored between 65 and 83 points on the Lysholm scale after one month; at six months, 72% scored between 84 and 100 points; after one year, 92% scored between 84 and 100 points; and the remaining 8% showed no improvement or required additional surgical procedures. The Q angle, TT-TG, and Fulkerson classification were correlated, obtaining P values of 0.65, 0.72, and 0.55 respectively, suggesting a positive correlation between these variables. Finally, the three variables were correlated for surgical decision-making, obtaining a P value of 0.85, with a positive and statistically significant correlation.
Conclusion:
The algorithm proposed in this study shows good results at the one-year follow-up and should be considered as a management option for patients with patellofemoral pathology.
Level Of Evidence:
IV. Observational retrospective case series study.
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