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Abstract
Background: Recurrent patellar subluxation is clinically manifested by slippage of patella and positive apprehension test. Fulkerson osteotomy of tibial tubercle is a well-known surgery for this type of patellar malalignment. Little data is available for changes of apprehension test after Fulkerson operation. The goal of this survey was assessment of Fulkerson surgery for patellar instability and its effect on apprehension test.Methods: In a clinical trial study, 12 patients (9 females, 3 males) with mean age of 38.3 years (28-60 years) underwent tibial tubercle osteotomy for symptomatic patellar subluxation. Mean follow-up time was 10 months (6-18 months). The pre and post operative assessment of change in “apprehension test”, knee function and radiographic changes were respectively evaluated by visual analog scale (VAS) and with Bristol pain score, Fulkerson scoring and lateral pattelo-femoral angle or Merchant view.Results: The results in 8 patients were excellent or good, 3 fair and one poor. Eight cases believed the surgery had been effective. The Fulkerson score of 48.75 improved to 71.6, while Bristol pain score of 7.3 decreased to 4.1 and VAS for apprehension test of 7.5 decreased to 5.16. The “Apprehension test” did not change in 3 patients, and one case developed significant limitation of motion.Conclusions: Fulkerson tibial tubercle osteotomy in selected patients improves knee function and decreases pain in short-term, but does not improve patellar alignment.
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