PMID- 31019984
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220408
IS  - 2325-9671 (Print)
IS  - 2325-9671 (Electronic)
IS  - 2325-9671 (Linking)
VI  - 7
IP  - 4
DP  - 2019 Apr
TI  - Concomitant Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle 
      Osteotomy Do Not Increase the Incidence of 30-Day Complications: An Analysis of 
      the NSQIP Database.
PG  - 2325967119837639
LID - 10.1177/2325967119837639 [doi]
LID - 2325967119837639
AB  - BACKGROUND: Lateral patellar dislocations account for 2% to 3% of total knee 
      injuries, especially in adolescents. Depending on the anatomic abnormality 
      contributing to lateral patellar instability, medial patellofemoral ligament 
      reconstruction (MPFLR) and/or tibial tubercle osteotomy (TTO) may be indicated. 
      PURPOSE: To assess the risk of adverse events (AEs) after TTO, MPFLR, and 
      concomitant MPFLR and TTO. STUDY DESIGN: Cohort study; Level of evidence, 3. 
      METHODS: Patients who underwent MPFLR, TTO, and concomitant MPFLR and TTO between 
      2005 and 2016 were identified through the American College of Surgeons-National 
      Surgical Quality Improvement Program (ACS-NSQIP) database. Medical complications 
      (eg, surgical site infection and deep vein thrombosis), readmission rates, and 
      extended hospital stay within 30 days of the procedure were recorded. Outcomes 
      were compared with bivariate and multivariate Poisson regression. RESULTS: Out of 
      882 patients, 617 (70.0%) underwent isolated MPFLR, 170 (19.3%) underwent TTO, 
      and 95 (10.8%) underwent concomitant MPFLR and TTO. The operative time for 
      concomitant MPFLR and TTO was significantly longer (122 +/- 45 minutes) compared 
      with isolated MPFLR (97 +/- 55 minutes; P < .001) and isolated TTO (89 +/- 51 
      minutes; P < .001). There were 32 AEs (3.6%), with 10 AEs in the isolated TTO 
      group (5.9%), 18 AEs in the isolated MPFLR group (2.9%), and 4 AEs in the MPFLR + 
      TTO group (4.2%). There was no significant difference in the rate of AEs between 
      the isolated MPFLR and isolated TTO groups (P = .1), isolated MPFLR and MPFLR + 
      TTO groups (P = .5), and isolated TTO and MPFLR + TTO groups (P = .8). Diabetes 
      mellitus was associated with an increased risk of developing an AE (odds ratio, 
      4.0; P = .003), and hypertension resulted in an increased risk of an extended 
      hospital stay (odds ratio, 4.0; P = .010). CONCLUSION: While concomitant MPFLR 
      and TTO significantly increased operative time, there was no difference in the 
      rate of AEs, extended hospital stay, and readmissions within 30 days after 
      isolated MPFLR, isolated TTO, and concomitant MPFLR and TTO.
FAU - Agarwalla, Avinesh
AU  - Agarwalla A
AD  - Department of Orthopaedic Surgery, Westchester Medical Center, Valhalla, New 
      York, USA.
FAU - Gowd, Anirudh K
AU  - Gowd AK
AD  - Department of Orthopaedic Surgery, Wake Forest University, Winston-Salem, North 
      Carolina, USA.
FAU - Liu, Joseph N
AU  - Liu JN
AD  - Department of Orthopedic Surgery, Loma Linda University Medical Center, Loma 
      Linda, California, USA.
FAU - Puzzitiello, Richard N
AU  - Puzzitiello RN
AD  - Department of Orthopaedic Surgery, Tufts University Medical Center, Boston, 
      Massachusetts, USA.
FAU - Yanke, Adam B
AU  - Yanke AB
AD  - Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, 
      USA.
FAU - Verma, Nikhil N
AU  - Verma NN
AD  - Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, 
      USA.
FAU - Forsythe, Brian
AU  - Forsythe B
AD  - Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20190412
PL  - United States
TA  - Orthop J Sports Med
JT  - Orthopaedic journal of sports medicine
JID - 101620522
PMC - PMC6463332
OTO - NOTNLM
OT  - NSQIP
OT  - complications
OT  - medial patellofemoral ligament
OT  - patellar dislocation
OT  - patellar instability
OT  - tibial tubercle osteotomy
COIS- One or more of the authors has declared the following potential conflict of 
      interest or source of funding: A.B.Y. has received research support from NuTech 
      and Arthrex; educational support from Medwest, Arthrex, and Smith & Nephew; and 
      consulting fees from Aastrom Biosciences and JRF Ortho. N.N.V. has received 
      research support from Arthrex, Arthrosurface, DJ Orthopaedics, Ossur, Athletico, 
      ConMed Linvatec, MioMed, and Mitek; educational support from Medwest; royalties 
      from Arthroscopy, Smith & Nephew, and Vindico Medical Education-Orthopedics 
      Hyperguide; consulting fees from Arthrex, Medacta, Minivasive, OrthoSpace, and 
      Smith & Nephew; nonconsulting fees from Pacira Pharmaceuticals; and stock options 
      from CyMedica, Minivasive, and Omeros. B.F. has received research support from 
      Arthrex and Stryker; honoraria from Arthrosurface; educational support from 
      Medwest, Smith & Nephew, and Ossur; consulting fees from Sonoma Orthopedics and 
      Stryker; royalties from Elsevier; and stock options from Jace Medical. AOSSM 
      checks author disclosures against the Open Payments Database (OPD). AOSSM has not 
      conducted an independent investigation on the OPD and disclaims any liability or 
      responsibility relating thereto.
EDAT- 2019/04/26 06:00
MHDA- 2019/04/26 06:01
PMCR- 2019/04/12
CRDT- 2019/04/26 06:00
PHST- 2019/04/26 06:00 [entrez]
PHST- 2019/04/26 06:00 [pubmed]
PHST- 2019/04/26 06:01 [medline]
PHST- 2019/04/12 00:00 [pmc-release]
AID - 10.1177_2325967119837639 [pii]
AID - 10.1177/2325967119837639 [doi]
PST - epublish
SO  - Orthop J Sports Med. 2019 Apr 12;7(4):2325967119837639. doi: 
      10.1177/2325967119837639. eCollection 2019 Apr.