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Treatment of patella baja by a modified Z-plasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

An Erratum to this article was published on 25 November 2016

Abstract

Purpose

The purpose of this study was to evaluate the efficiency of a modified Z-plasty for patellar tendon lengthening for the treatment of patella baja. Rather than adapting only two tendon reins according to the conventional Z-plasty method, the modified Z-plasty provides four reins to enable multifold overlapping of the tendon tissue.

Methods

Between 2010 and 2012, a modified Z-plasty procedure was performed in four patients suffering from patella baja. Physical examinations and standardized scoring instruments served as the evaluation measures.

Results

The median preoperative CD ratio of 0.53 (range 0.43–0.62) was corrected to 1.03 (range 1–1.06) after a median follow-up of 34 months (range 23–41 months). The median preoperative flexion of 108° (range 80–135°) improved to 143° (range 110–145°) compared with the flexion of 145° (range 140–145°) of the unaffected knee. No patients showed any signs of extension lag. The median Lysholm score improved from 49 (range 22–80) to 91 (range 67–95), and the Tegner activity level improved from 2 (range 0–6) to 6 (range 2–6). The median VAS status for pain decreased from an average of 8.5 (range 4–10) to 1 (range 0–2). No complications were observed.

Conclusion

The modified Z-plasty procedure is a valuable technique for the treatment of patella baja, especially if allografts are not available. This procedure allowed for early mobilization and achieved excellent clinical results.

Level of evidence

IV.

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Acknowledgments

We thank Caroline Hepperger from the OSM Research Foundation for her highly motivated contribution in collecting the clinical data used for this study.

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Authors and Affiliations

  1. Sportsclinic Austria, Innsbruck, Olympiastraße 39, 6020, Innsbruck, Austria

    Wierer Guido, Hoser Christian, Herbst Elmar, Abermann Elisabeth & Fink Christian

  2. Department of Traumatology and Sports Injuries, Paracelsus Medical University, Salzburg, Muellner Hauptstrasse 48, 5020, Salzburg, Austria

    Wierer Guido

  3. Department of Orthopaedic Sports Medicine, Technical University Munich, Ismaninger Strasse 22, 81675, Munich, Germany

    Herbst Elmar

Authors
  1. Wierer Guido
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  2. Hoser Christian
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  3. Herbst Elmar
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  4. Abermann Elisabeth
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  5. Fink Christian
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Corresponding author

Correspondence to Fink Christian.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s00167-016-4389-2.

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Guido, W., Christian, H., Elmar, H. et al. Treatment of patella baja by a modified Z-plasty. Knee Surg Sports Traumatol Arthrosc 24, 2943–2947 (2016). https://doi.org/10.1007/s00167-015-3576-x

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