{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T01:26:05Z","timestamp":1773019565753,"version":"3.50.1"},"reference-count":0,"publisher":"AVES YAYINCILIK A.\u015e.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AOTT"],"abstract":"<jats:p>Abstract\n\nObjectives: We evaluated the results of a modified Fulkerson technique performed for the treatment of recurrent patellofemoral dislocations.\\r\\nMethods: The study included 17 knees of 16 patients (11 males, 5 females; mean age 25 years; range 15 to 43 years) who were operated on by the same surgeon for patellofemoral alignment disorders. The mean duration of complaints was 3.4 years (range 1 to 12 years). Preoperatively, the number of recurring dislocations were 1 to 5 in three knees, 6 to 10 in five knees, and more than 10 in nine knees, and all the patients had a positive apprehension test and a Q angle exceeding 15 degrees. All the knees were assessed by preoperative and postoperative radiographs and computed tomography, which showed both subluxation and patellar tilt in all the knees, and trochlear dysplasia in two knees preoperatively. During surgery, diagnostic arthroscopy was performed in all the patients. The skin incision consisted of two horizontal incisions for cosmetic reasons. Surgical treatment was comprised of lateral patellar release to correct patellar tilt, and a modified Fulkerson osteotomy to correct patellofemoral malalignment, and medial plication in three knees. The patellofemoral congruity following lateral release, and the position of the patella following osteotomy and anteromedialization of the tibial tuberosity were checked arthroscopically. On control examinations, the patients were administered functional scoring questionnaires developed by Kujala et al. and Crosby and Insall. Radiographic grading of osteoarthritis was made according to the classification developed by Iwano et al. and modified by Palmer et al. The mean follow-up period was 2.6 years (range 24 to 53 months).\\r\\nResults: During arthroscopy, eight knees had severe (Outerbridge grade III-IV) and nine knees had moderate (grade I-II) retropatellar cartilage damage. Follow-up evaluations showed effusion in two knees, subluxation in two knees, and a positive apprehension test in three knees. The mean flexion loss was 8\u00b0 (range 0\u00b0 to 20\u00b0). One patient who had an extension loss of 10\u00b0 regained full extension following a six-week physical therapy program. Postoperative computed tomography scans showed that patellar tilt and subluxation were corrected in all but two knees. Preoperative radiographies showed degenerative arthritis in the tibiofemoral joint in one knee (5.9%), and in the patellofemoral joint in seven knees (41.2%). The number of knees with degenerative changes increased postoperatively to three knees (17.3%) in the tibiofemoral joint, and to 11 knees (64.7%) in the patellofemoral joint. According to the Crosby-Insall scoring system, five knees had excellent, seven knees had good, and five knees had moderate scores. The mean Kujala score was 82.6 (range 44 to 100) postoperatively.\\r\\nConclusion: Our results show that, with appropriate indications, the modified Fulkerson method is associated with successful results in the treatment of recurrent patellofemoral dislocations.\n\n\u00d6zet\n\nAma\u00e7: Bu \u00e7al\u0131\u015fmada, tekrarlayan patellofemoral \u00e7\u0131k\u0131klar nedeniyle modifiye Fulkerson y\u00f6ntemi uygulanan olgularda tedavi sonu\u00e7lar\u0131 de\u011ferlendirildi.\\r\\n\u00c7al\u0131\u015fma plan\u0131: Patellofemoral dizilim bozuklu\u011fu nedeniyle ayn\u0131 cerrah taraf\u0131ndan ameliyat edilen 16 hastan\u0131n (11 erkek, 5 kad\u0131n; ort. ya\u015f 25; da\u011f\u0131l\u0131m 15-43) 17 dizi incelendi. Ameliyat \u00f6ncesi yak\u0131nmalar\u0131n s\u00fcresi ortalama 3.4 y\u0131l (da\u011f\u0131l\u0131m 1-12 y\u0131l) idi. Ameliyat \u00f6ncesinde \u00e7\u0131k\u0131k say\u0131s\u0131 \u00fc\u00e7 dizde 1-5, be\u015f dizde 6-10 aras\u0131nda, dokuz dizde ise 10\u2019dan fazlayd\u0131. T\u00fcm hastalarda ameliyat \u00f6ncesi endi\u015fe testi pozitif ve Q a\u00e7\u0131s\u0131 15 derecenin \u00fczerinde bulundu. T\u00fcm dizler ameliyat \u00f6ncesi ve sonras\u0131nda d\u00fcz grafiler ve bilgisayarl\u0131 tomografi ile incelendi ve ameliyat \u00f6ncesinde t\u00fcm dizlerde subluksasyon ve patellar tilt, iki hastada troklear displazi saptand\u0131. T\u00fcm hastalarda ameliyat s\u0131ras\u0131nda tan\u0131sal artroskopiden yararlan\u0131ld\u0131. Cilt insizyonu kozmetik nedenlerle iki farkl\u0131 yatay kesi ile yap\u0131ld\u0131. T\u00fcm dizlere patellar tiltin d\u00fczeltilmesi i\u00e7in lateral patellar gev\u015fetme, subluksasyon ve dizilim bozuklu\u011funun d\u00fczeltilmesi i\u00e7in modifiye Fulkerson osteotomisi uyguland\u0131. \u00dc\u00e7 dizde ek olarak medial plikasyon yap\u0131ld\u0131. Lateral gev\u015fetme sonras\u0131nda patellofemoral uyum ve t\u00fcberositas tibiada osteotomi ve anteromedializasyon sonras\u0131 patella pozisyonu artroskopik olarak kontrol edildi. Hastalara ameliyat sonras\u0131nda Kujala ve ark. ve Crosby-Insall taraf\u0131ndan geli\u015ftirilen fonksiyonel skorlama \u00e7izelgeleri uyguland\u0131. Radyografik osteoartrit derecelendirmesinde, Palmer ve ark. taraf\u0131ndan modifiye edilen Iwano ve ark.n\u0131n s\u0131n\u0131flama sistemi kullan\u0131ld\u0131. Ortalama takip s\u00fcresi 2.6 y\u0131l (da\u011f\u0131l\u0131m 24 ay-53 ay) idi. \\r\\nSonu\u00e7lar: Artoskopi s\u0131ras\u0131nda sekiz dizde patella arkas\u0131 k\u0131k\u0131rdakta ciddi hasar (Outerbridge derece III-IV), dokuz dizde orta derecede hasar (derece I-II) saptand\u0131. Ameliyat sonras\u0131 takiplerde 17 dizden ikisinde ef\u00fczyon, ikisinde devam eden subluksasyon saptand\u0131, \u00fc\u00e7 dizde endi\u015fe testi pozitif idi. Fleksiyon kayb\u0131 ortalama 8\u00ba (da\u011f\u0131l\u0131m 0\u00ba-20\u00ba) bulundu, bir hastada izlenen 10 derecelik ekstansiyon kayb\u0131 alt\u0131 haftal\u0131k fizik tedavi sonras\u0131nda tamamen d\u00fczeldi. Ameliyat sonras\u0131 tomografik incelemede iki olgu d\u0131\u015f\u0131nda t\u00fcm olgularda subluksasyon ve tiltin d\u00fczelmi\u015f oldu\u011fu izlendi. Ameliyat \u00f6ncesi grafilerde tibiofemoral eklemde bir dizde (%5.9), ameliyat sonras\u0131nda \u00fc\u00e7 dizde (%17.7); patellofemoral eklemde ise ameliyat \u00f6ncesinde yedi dizde (%41.2), ameliyat sonras\u0131nda 11 dizde (%64.7) dejeneratif artrit bulgular\u0131 saptand\u0131. Crosby-Insall skorlama sistemine g\u00f6re, sonu\u00e7lar be\u015f dizde m\u00fckemmel, yedi dizde iyi, be\u015f dizde ise orta olarak de\u011ferlendirildi. Ameliyat sonras\u0131nda Kujala skoru ortalamas\u0131 82.6 (da\u011f\u0131l\u0131m 44-100) bulundu.\\r\\n\u00c7\u0131kar\u0131mlar: Bulgular\u0131m\u0131z, do\u011fru endikasyon konuldu\u011funda, tekrarlayan patellofemoral eklem \u00e7\u0131k\u0131klar\u0131n\u0131n tedavisinde modifiye Fulkerson y\u00f6nteminin ba\u015far\u0131l\u0131 sonu\u00e7lar sa\u011flad\u0131\u011f\u0131n\u0131 g\u00f6stermektedir.<\/jats:p>","DOI":"10.3944\/aott.2010.2143","type":"journal-article","created":{"date-parts":[[2010,5,26]],"date-time":"2010-05-26T17:11:11Z","timestamp":1274893871000},"page":"27-35","source":"Crossref","is-referenced-by-count":21,"title":["Modified Fulkerson osteotomy in recurrent patellofemoral dislocations"],"prefix":"10.5152","volume":"44","author":[{"given":"Umut","family":"Akgun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rustu","family":"Nuran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa","family":"Karahan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3111","published-online":{"date-parts":[[2020,2,8]]},"container-title":["Acta Orthopaedica et Traumatologica Turcica"],"original-title":[],"link":[{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/download\/2348\/2305","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T10:56:51Z","timestamp":1763463411000},"score":1,"resource":{"primary":{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/view\/2348"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,8]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2010,1,1]]}},"URL":"https:\/\/doi.org\/10.3944\/aott.2010.2143","relation":{},"ISSN":["2589-1294","1017-995X"],"issn-type":[{"value":"2589-1294","type":"electronic"},{"value":"1017-995X","type":"print"}],"subject":[],"published":{"date-parts":[[2020,2,8]]}}}