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Trochleoplasty Utilization in the Management of Patellofemoral Instability: Results From an International Survey of Surgeons.
Orthop J Sports Med
January 2025
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Background: Considerable variability exists in the described clinical and radiographic indications for use, surgical techniques, postoperative management, and risk profile after trochleoplasty for the management of patellofemoral instability (PFI). In areas of clinical uncertainty, a cohesive summary of expert opinion and identification of areas of variation in current practice can be useful in guiding current practice and future research efforts.
Purpose: To assess the current indications for use, surgical techniques, postoperative rehabilitation practices, and observed complication profile for trochleoplasty in the management of PFI among surgeons who perform this procedure.
HKA angle exceeding 5 degrees is strongly associated with lateral patellar translation beyond 2 mm: surgical recommendations for avoiding adverse effects on the patellofemoral joint after OWHTO.
J Orthop Surg Res
January 2025
Department of Orthopedics, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China.
Purpose: Previous studies reported that anterior knee pain (AKP) occurs with an incidence of 32% after opening-wedge high tibial osteotomy (OWHTO). However, the biomechanical effects of this procedure on patellofemoral joints (PFJs) remain unclear. We aimed to quantify the changes in the kinematics and cartilage conditions of the PFJ during stair climbing before and after OWHTO.
View Article and Find Full Text PDFSulcus-Deepening Trochleoplasty and Medial Patellofemoral Ligament Reconstruction Provide Good Clinical Outcomes in Addressing Patellar Instability at Mid-Term Follow-Up: A Retrospective Case Series.
J ISAKOS
January 2025
University of Virginia Health System, Department of Orthopaedic Surgery, Charlottesville, VA, USA.
Purpose: To update previously published clinical and radiographic outcomes of Dejour sulcus-deepening trochleoplasty and medial patellofemoral ligament reconstruction (MPFL-R), at mid-term follow-up, and monitor trends in patient reported outcome scores and satisfaction.
Methods: Using the same cohort of patients from our previously published short-term series of 2-year follow up, interval follow-up was performed on 67 patients (76 knees) with severe trochlear dysplasia and recurrent patellar instability who were prospectively enrolled and underwent Dejour sulcus-deepening trochleoplasty and MPFL-R combined with other patellar-stabilization procedures. Patients with less than 2-year follow-up were excluded.
Association of patellofemoral osteoarthritis on patient-reported outcomes after medial unicompartmental knee arthroplasty: a retrospective cohort study.
Acta Orthop
January 2025
Clinical Orthopaedic Research Hvidovre, Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
Background And Purpose: In contemporary medial unicompartmental knee arthroplasty (mUKA), non-lateral patellofemoral osteoarthritis (PFOA) is not considered a contraindication. However, we still lack knowledge on the association of PFOA severity on patient reported outcome measures (PROMs) after mUKA. We aimed to examine the association between PFOA severity and PROM-score changes after mUKA.
View Article and Find Full Text PDFAll-Soft-Tissue Medial Patellofemoral Complex Reconstruction for Revisions and Skeletally Immature Knees.
Arthrosc Tech
December 2024
Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.
The medial patellofemoral complex provides the primary static restraint to lateral patellar translation and is composed of the medial patellofemoral ligament and medial quadriceps tendon femoral ligament. Multiple techniques including medial patellofemoral ligament and/or medial quadriceps tendon femoral ligament reconstruction have demonstrated good results; however, modification of the femoral fixation technique is required for skeletally immature patients or revision cases in which anatomic bony fixation on the femur is not possible. This technique describes an all-soft-tissue procedure for single-bundle medial patellofemoral complex reconstruction in which the graft is fixed on the adductor tendon while using the medial collateral ligament as a distalizing pulley, for anatomic and isometric recreation of the native ligament.
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