Trochleoplasty as a Solitary Treatment for Recurrent Patellar Dislocation Results in Good Clinical Outcome in Adolescents

Camathias, Carlo; Studer, Katrin; Kiapour, Ata; Rutz, Erich; Vavken, Patrick

doi:10.1177/0363546516652894

Cited by 58 publications

(63 citation statements)

References 46 publications

(45 reference statements)

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“…The salient finding of the present study is that the mean TA showed a significant positive correlation with Dejour type from B to D. Many studies have recommended that severe trochlear dysplasia should be corrected by a tracheloplasty procedure for long-term patellar stability [ 15 – 19 ]. Several investigators have deemed severe trochlear dysplasia to be a significant negative prognostic risk factor for other procedures performed without managing trochlear dysplasia [ 20 ].…”

Section: Discussionmentioning

confidence: 49%

Evaluation of Trochlear Dysplasia Severity Using Trochlear Angle: A Retrospective Study Based on Computed Tomography (CT) Scans

et al. 2018

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BackgroundTrochlear dysplasia is an important pathological factor in patellofemoral instability. Quantitative evaluation of the severity of trochlear dysplasia is rare and remains unclear.Material/MethodsComputed tomography (CT) data on 136 knees (95 patients) with trochlear dysplasia in the case group and an age- and sex-matched cohort of 120 knees (70 patients) in the control group were collected for this retrospective study. All participants had undergone CT scans in the supine position. The trochlear angles (TA) formed by the posterior condylar line and the trochlear line were calculated and compared. The threshold for statistical significance was set at p<0.05.ResultsThe mean TA values were significantly greater in the case group compared to the control group independent of sex (p<0.01). The distribution of trochlear dysplasia of Dejour grades was type A n=34, type B n=31, type C n=40, and type D n=31. Except for types A and B, differences in the trochlear dysplasia grade between any 2 other types were statistically significant (p<0.01).ConclusionsThe technique of measuring TA is reproducible and accurate in patients with patellar instability and normal controls. The TA positively correlates with higher levels of trochlear dysplasia. This technique can help to evaluate and treat trochlear dysplasia in research as well as in clinical practice.

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Section: Discussionmentioning

confidence: 49%

Evaluation of Trochlear Dysplasia Severity Using Trochlear Angle: A Retrospective Study Based on Computed Tomography (CT) Scans

et al. 2018

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“…Today, open trochleoplasty techniques include (1) lateral-facet elevation trochleoplasty, which deepens the trochlear groove by elevating the lateral facet of the femoral condyle and was first reported by Albee; (2) sulcus-deepening trochleoplasty, which includes 2 types, Dejour sulcus deepening (“Lyon procedure”) with a thick osteochondral flap and V-shaped osteotomy 10 and Bereiter-Gautier subchondral sulcus deepening with a thin osteochondral flap and U-shaped osteotomy 11 ; and (3) recession wedge trochleoplasty. 12 The first 2 trochleoplasty procedures have been the most commonly used techniques in recent years.…”

Section: Discussionmentioning

confidence: 99%

“…Trochleoplasty, as a solitary or concomitant treatment for recurrent patellar instability, is associated with significantly improved stability and function. 4 , 11 , 13 Nevertheless, trochleoplasty is still a daunting procedure for surgeons because of its multiple and gloomy complications. A 15-year follow-up study of trochleoplasty reported that 20% of patients had total failure and 23% of patients identified postoperative stiffness at less than 90° of flexion.…”

Section: Discussionmentioning

confidence: 99%

Precise Arthroscopic Mini-trochleoplasty and Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability With Severe Trochlear Dysplasia

Ding

Wang

et al. 2020

Arthroscopy Techniques

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More than 100 surgical procedures have been reported to address recurrent patellar instability. Trochlear dysplasia is the most common finding among the anatomic risk factors for recurrent patellar instability. Various studies have shown that trochleoplasty combined with medial patellofemoral ligament reconstruction is an effective technique to treat recurrent patellar instability. Nevertheless, trochleoplasty is still a daunting procedure for surgeons because of its multiple and gloomy complications. This article introduces a technique to treat recurrent patellar instability with severe trochlear dysplasia: precise arthroscopic mini-trochleoplasty (PAM trochleoplasty) combined with medial patellofemoral ligament reconstruction. This technique precisely removes the supratrochlear spur and trochlear bump, accurately reshapes the trochlear sulcus with minimal invasion and less osteotomy volume, and keeps the sulcus cartilage intact. The purpose of this technique is to develop trochleoplasty into a common and safe technique, which has good outcomes and low complications.

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“…It can lead to various complications. Camathias et al [18] described recurrent patellar dislocations associated with isolated trochleoplasty outcomes. Precise planning is needed before the surgery to avoid uncommon complications, such as articular surface damages, overcorrection, and recurrent instability [11].…”

Section: Discussionmentioning

confidence: 99%

Femoral Trochleoplasty for Recurrent Patellar Dislocation: Treating the Underlying Trochlear Dysplasia

Santos

Ranger

Delisle

et al. 2018

Case Rep Orthop Res

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The patellofemoral joint presents a complex biomechanical interaction involving soft tissues and bony structures to maintain joint stability. The most relevant factor is trochlear dysplasia which is present in 85% of patients. Femoral trochleoplasty is a surgical procedure to recreate the trochlear groove. This case report describes a young patient who had all clinical factors of patellar instability and trochlear dysplasia. Radiology studies showed trochlear dysplasia type C according to the Dejour classification. The patient underwent a trochleoplasty with an elevated flap of cartilage and subchondral bone as described by Ryzek and Schöttle [J Knee Surg 2015; 28(4): 297–302], associated with the reconstruction of the medial patellofemoral ligament. Femoral trochleoplasty is a surgical procedure to recreate the trochlear groove by removing subchondral bone to create a new trochlear sulcus, while respecting the kinematics and biomechanics of the patellofemoral joint.

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Trochleoplasty as a Solitary Treatment for Recurrent Patellar Dislocation Results in Good Clinical Outcome in Adolescents

Cited by 58 publications

References 46 publications

Evaluation of Trochlear Dysplasia Severity Using Trochlear Angle: A Retrospective Study Based on Computed Tomography (CT) Scans

Evaluation of Trochlear Dysplasia Severity Using Trochlear Angle: A Retrospective Study Based on Computed Tomography (CT) Scans

Precise Arthroscopic Mini-trochleoplasty and Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability With Severe Trochlear Dysplasia

Femoral Trochleoplasty for Recurrent Patellar Dislocation: Treating the Underlying Trochlear Dysplasia

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