Outcomes After Derotational Distal Femoral Osteotomy for Recurrent Patellar Dislocations With Increased Femoral Anteversion: A Systematic Review and Meta-analysis

Background: An increased femoral anteversion angle (FAA) is a predisposing factor for recurrent patellar dislocations (RPDs), and combined procedures including derotational distal osteotomy (DDFO) have been shown to be good options. Purpose: To investigate the safety effectiveness of DDFO on clinical radiological outcomes treat RPDs with an FAA. Study Design: Systematic review; Level evidence, 4. Methods: This review was performed according PRISMA (Preferred Reporting Items Reviews Meta-analyses) guidelines. We searched 7 databases articles from inception March 10, 2023, that reported after in patients RPD Two reviewers independently extracted data assessed study quality. Outcomes evaluated were functional scores, redislocation rates, complications, satisfaction, parameters. A meta-analysis pool as mean differences (MDs) 95% confidence intervals (CIs). Results: Included 8 studies 189 knees 183 patients, patient age 22.4 years follow-up 33.4 months. The preoperative FAA ranged 31° 42.70°, postoperative 10° 19.08°. Significant improvements found Kujala score (MD, 26.96 [95% CI, 23.54 30.37]), Lysholm 26.17 22.13 30.22]), visual analog scale pain –2.61 –3.12 –2.10]), Tegner activity 1.33 0.86 1.79]). No subluxation or occurred. overall complication rate 10.6%, most complications (60%) limited knee (20%). satisfaction 83.3%. tilt significantly decreased 40.7° ± 11.9° 20.5° 8.7° 26.35° 6.86° 11.65° 2.85° 2 studies. Conclusion: Combined safe effective treatment by addressing both torsional malalignment. However, because lack comparisons, it remains investigated when should such patients.