Simplification of the Elmslie-Trillat procedure for patellofemoral malalignment

Abstract

We describe a modification of the Elmslie-Trillat operation which includes a lateral retinacular release and medial realignment of the tibial tuberosity, but omits medial capsulorraphy. Seventy-five patients were reviewed with a follow up longer than 2 years and the results compared with the conventional Elmslie-Trillat procedure, which consists of lateral release, medial realignment of the tuberosity and medial capsulorraphy. The simpler operation can work as well and the period of rehabilitation is shorter. The incidence of injury to the saphenous nerve is reduced and the cosmetic appearance is more satisfactory. We conclude that medial capsulorraphy is usually unnecessary in this type of procedure.

The Incidence of Complications of Tibial Tubercle Osteotomy: A Systematic Review

“…Ten studies reported the incidence of symptomatic hardware removal, [12][13][14][15][16][17]19,20,23,25 7 studies made no mention of symptomatic hardware, [9][10][11]18,21,26,27 and all hardware was removed regardless of symptoms in …”

“…There were 472 direct medialization procedures (ElmslieTrillat technique) in 11 studies, [10][11][12]14,15,17,19,[22][23][24]26 193 anteromedialization procedures (Fulkerson technique) in 5 studies, 9,13,20,25,27 and 102 procedures in 3 studies 16,18,21 in which the tibial tubercle was completely detached for medialization, distalization, or a combination.…”

“…The 2 exceptions were studies that were performed in military populations. 11,14 The majority of studies included only patients being treated for patellar instability, 9,10,13,14,[17][18][19]21,22,[24][25][26][27] whereas the remainder included patients with instability, as well as those with pain and patellar malalignment (Table 2). 11,12,15,16,20,23 The risk of complications ranged from 0% to 11% in the individual studies ( Table 3).…”

“…The remaining 19 articles were used in this review (Fig 1). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Data were extracted using a template and included study characteristics, patient demographics, surgical technique, length of follow-up, and complications. Complications, for purposes of this review, were defined as osteotomy site nonunion, fracture, infection, wound complications, neurovascular complications, deep vein thrombosis (DVT), and pulmonary embolism (PE).…”

Modified Elmslie–Trillat Procedure for Recurrent Dislocation of the Patella

“…The surgical technique of the modified ET procedure was performed as reported by Tomatsu et al 12 First, the condition of the cartilage and tracking of the patellofemoral joint were observed by arthroscopy. Arthroscopic treatment for cartilaginous injury was performed whenever possible.…”