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Hospital General Gregorio Maranon, Madrid, Spain.
The authors describe an original procedure, the patella thinning osteotomy, as an alternative to advancement of the tibial tuberosity or patellectomy in cases of severe anterior knee pain. They present an experimental study on cadaveric knees prior to a clinical trial. This study on 13 knee specimens, using Fujifilm Prescale barosensitive film, shows that thinning of the patella by 7 mm diminishes to a significant degree the patellofemoral contact areas from 16.07% at 60 degrees of flexion to 27.90% at 30 degrees of flexion. Patellofemoral joint reacting forces, measured in 12 knees, also diminish in both medial and lateral surfaces at 30 degrees, 60 degrees and 90 degrees of flexion, the level of statistical significance being over 0.05, except for the lateral surface at 60 degrees of flexion. This technique decompresses the patellofemoral joint, and produces the biological effects found after other osteotomies.
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