4 Efficacy
This section describes efficacy outcomes from the published literature that the Committee considered as part of the evidence about this procedure. For more detailed information on the evidence, see the overview. The only available literature on efficacy was 1 case series of 31 patients with recurrent patellar dislocation and trochlear dysplasia type B to D.
4.1
A case series of 31 patients reported outcomes for 29 knees with a median follow‑up of 29 months. The median Kujala score (scores range from 0 to 100 with higher scores indicating less severe symptoms) improved from 64 before the procedure to 95 at follow‑up. The median Tegner score (scores range from 0 to 10 with higher scores indicating higher activity levels) improved from 4 before the procedure to 6 at follow‑up. The median knee injury and osteoarthritis outcome scores for pain, symptoms, activities of daily living, sport and quality of life improved from 86, 82, 91, 40 and 25 before the procedure to 94, 86, 99, 85 and 75 respectively at follow‑up (all p values <0.001).
4.2
The case series of 31 patients reported that patients were satisfied with the outcome of the operation for 93% (27 out of 29) of knees.
4.3
The case series of 31 patients reported that 17% (5 out of 29) of knees needed further surgery. Two patients developed symptomatic subluxations 28 months after the procedure and were both treated by medialisation of the tibial tubercle. Three patients had pronounced postoperative anterior knee pain at flexion and had tightness of the lateral retinaculum, indicating lateral hyper‑pressure syndromes; all were subsequently treated by lateral releases.
4.4
The case series of 31 patients reported that there were no redislocations over a median follow‑up of 29 months.
4.5
The specialist advisers listed additional efficacy outcomes as including International Knee Documentation Committee scores, and radiological outcomes such as patellar tilt and sulcus angle.