The epidemiology of Surgical Procedures for
Description: The epidemiology of Surgical Procedures for patellar instability in the JUPITER Cohort Marc Tompkins, MD Matthew Veerkamp Shital Parikh, MD Beth Shubin Stein, MD Disclosures This study is supported by grants from: Arthorscopy Association of
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slide1. The epidemiology of Surgical Procedures for patellar instability in the JUPITER Cohort Marc Tompkins, MD
Matthew Veerkamp
Shital Parikh, MD
Beth Shubin Stein, MD<br>
slide2. Disclosures This study is supported by grants from:
Arthorscopy Association of North America (AANA)
Pediatric Orthopaedic Society of North America (POSNA)
ConMed Corporation
University of Cincinnati Faculty Grant.<br>
slide3. Background The Justifying Patellar Instability Treatment by Early Results (JUPITER) study is a hypothesis-driven, multi-center, multi-armed, prospective cohort study developed to obtain sufficient subjects to better describe clinical characteristics and predictors of clinical outcomes in the patellar instability population
Represents a cohort of patients from busy patellofemoral surgeons at 11 centers<br>
slide4. Purpose Understanding what procedures are performed in a large cohort such as JUPITER will give an overview of the most common ways being used to address patellofemoral instability
Report surgical procedures utilized for all JUPITER patients<br>
slide5. Methods 1437 operative patients
All surgical procedures are documented in the database
Database queried to evaluate the different surgical procedures included in JUPITER cohort
Percent of patients undergoing each procedure is reported<br>
slide6. Results MPFL reconstruction was performed on 1129Â (79%) patients
Lateral release was performed on 234 (16%) patients
Lateral retinacular lengthening was performed on 102 (7%) patients<br>
slide7. Results Several variations of tibial tubercle osteotomy performed
Anteromedialization 160 (11%) patients
Direct medial 88 (6%) patients
Maquet 6 (<1%) patients
Distalization 53Â (4%) patients<br>
slide8. Results Less common procedures
Trochleoplasty 30 (2%) patients
Distal femoral osteotomy 18 (1%)Â patients
Primarily lateral opening wedge
Femoral derotation osteotomy 10 (<1%) patients
Tibial derotation osteotomy 6Â (<1%) patients
Quadricepsplasty 12Â (<1%) patients<br>
slide9. Limitations Surgical decision making not standardized among sites or surgeons
Not clear that all operative patellofemoral patients for each surgeon included in the study<br>
slide10. Conclusion Many procedures available in the armamentarium of a patellofemoral surgeon
In the JUPITER cohort, the majority of patients underwent MPFL reconstruction
A lateral retinacular procedure was included in roughly a quarter of the patients<br>
slide11. Conclusion Tibial tubercle osteotomy was part of treatment for roughly 20% of patients
A variety of types of TTOs performed
Other procedures were much less frequent
In all comers of patients with patellofemoral instability, MPFL alone was often used, but surgeons also employed a broad range of surgical procedures<br>
slide12. Thank you!<br>
Matthew Veerkamp
Shital Parikh, MD
Beth Shubin Stein, MD<br>
slide2. Disclosures This study is supported by grants from:
Arthorscopy Association of North America (AANA)
Pediatric Orthopaedic Society of North America (POSNA)
ConMed Corporation
University of Cincinnati Faculty Grant.<br>
slide3. Background The Justifying Patellar Instability Treatment by Early Results (JUPITER) study is a hypothesis-driven, multi-center, multi-armed, prospective cohort study developed to obtain sufficient subjects to better describe clinical characteristics and predictors of clinical outcomes in the patellar instability population
Represents a cohort of patients from busy patellofemoral surgeons at 11 centers<br>
slide4. Purpose Understanding what procedures are performed in a large cohort such as JUPITER will give an overview of the most common ways being used to address patellofemoral instability
Report surgical procedures utilized for all JUPITER patients<br>
slide5. Methods 1437 operative patients
All surgical procedures are documented in the database
Database queried to evaluate the different surgical procedures included in JUPITER cohort
Percent of patients undergoing each procedure is reported<br>
slide6. Results MPFL reconstruction was performed on 1129Â (79%) patients
Lateral release was performed on 234 (16%) patients
Lateral retinacular lengthening was performed on 102 (7%) patients<br>
slide7. Results Several variations of tibial tubercle osteotomy performed
Anteromedialization 160 (11%) patients
Direct medial 88 (6%) patients
Maquet 6 (<1%) patients
Distalization 53Â (4%) patients<br>
slide8. Results Less common procedures
Trochleoplasty 30 (2%) patients
Distal femoral osteotomy 18 (1%)Â patients
Primarily lateral opening wedge
Femoral derotation osteotomy 10 (<1%) patients
Tibial derotation osteotomy 6Â (<1%) patients
Quadricepsplasty 12Â (<1%) patients<br>
slide9. Limitations Surgical decision making not standardized among sites or surgeons
Not clear that all operative patellofemoral patients for each surgeon included in the study<br>
slide10. Conclusion Many procedures available in the armamentarium of a patellofemoral surgeon
In the JUPITER cohort, the majority of patients underwent MPFL reconstruction
A lateral retinacular procedure was included in roughly a quarter of the patients<br>
slide11. Conclusion Tibial tubercle osteotomy was part of treatment for roughly 20% of patients
A variety of types of TTOs performed
Other procedures were much less frequent
In all comers of patients with patellofemoral instability, MPFL alone was often used, but surgeons also employed a broad range of surgical procedures<br>
slide12. Thank you!<br>