Trochlear dysplasia is a risk factor for patellofemoral instability. Trochleoplasty involves reshaping the trochlear groove to provide increased patellofemoral stability. We obtained post-operative radiographs, MRI, and outcome scores in 6 patients who underwent this procedure. All 6 of the patients were satisfied with their outcome following trochleoplasty with no recurrent instability events. Mean bony sulcus angles decreased from 148 degrees to 129 degrees. However, 4 of the 6 patients reported anterior knee pain. Similar to previously published studies, trochleoplasty can reliably improve patellofemoral stability in patients with severe trochlear dysplasia, but a high percentage of patients will have pain postoperatively.
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Orthop J Sports Med
January 2025
Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Background: Tibiofemoral rotation is an emerging parameter, especially in assessing patellofemoral instability. However, reference values in the literature are inconsistent regarding the used imaging modality and do not consider the effect of knee flexion during image acquisition.
Purpose: To analyze the differences in tibiofemoral rotation measurements between computed tomography (CT) and magnetic resonance imaging (MRI).
Iowa Orthop J
January 2025
Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Background: Trochleoplasty is a surgical consideration for the treatment of high-grade trochlear dysplasia. The safety profile of this procedure remains particularly unclear in the skeletally immature population where concerns exist regarding physeal arrest and the development of premature patellofemoral arthritis. The purpose of this study was to systematically review the literature to evaluate trochleoplasty use, outcomes and complications observed among pediatric patients.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
January 2025
Sports Medicine Service, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
Purpose: To propose a new sign of patellar maltracking in recurrent patellar dislocation (RPD) and compare the differences in lower limb rotational and bony structural abnormalities among the different signs.
Patients And Methods: A retrospective study included 279 patients (mean age: 22 years; female: 81%) who underwent primary surgery for RPD over the past 4 years was performed. The patients were grouped based on the characteristics of patellar tracking: low-, moderate- and high-grade J-sign.
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.
Purpose: Tibial rotational deformity is a known risk factor for patellofemoral joint (PFJ) disorders. However, it is commonly associated with other abnormalities which affect the PFJ. The purpose of this study was to describe the prevalence of associated factors known to affect PFJ in patients undergoing rotational tibial osteotomy and their implication for the correction level.
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