Trochleoplasty in Patellofemoral instability: current concepts
Location
LSUHSC Center for Advanced Learning and Simulation (CALS)
Document Type
Presentation
Start Date
22-6-2024 10:30 AM
End Date
22-6-2024 11:25 AM
Publication Date
June 2024
Description
Purpose: Trochlear dysplasia is a significant anatomical and biomechanical risk factor for recurrent patella instability. Trochleoplasty is a surgical procedure that has been described to manage patients with high grade trochlea dysplasia leading to recurrent patella instability. This review aims to describe the current evidence on indications, types of Trochleoplasty, surgical techniques as well as clinical outcomes of Trochleoplasty. Recent findings: Three types of Trochleoplasty that have been described include lateral facet elevation, recession wedge and sulcus deepening Trochleoplasty. The modified Bereiter ‘thin flap’ is the most common type of sulcus deepening procedure which is being performed in recent years compared to the Dejour ‘thick flap’ technique. A recent advancement is the arthroscopic deepening trochleoplasty, which is an arthroscopic variant of the Bereiter technique. In contrast to historical literature, recent studies have reported significant improvement in patient reported outcome measures (PROMs), improved patellofemoral stability and elevated levels of patient satisfaction. Summary: Sulcus deepening Trochleoplasty is a proven technique for management of patients with High grade Trochlear dysplasia associated with patellofemoral instability. It is associated with lower re-dislocation incidence, minimal complication rates, improved clinical outcomes and good patient satisfaction scores. Surgeons managing patellofemoral instability patients should be well versed with the indications and technique of Trochleoplasty.
Recommended Citation
Mudiganty, Srikanth, "Trochleoplasty in Patellofemoral instability: current concepts" (2024). Dept. of Orthopaedics: Robert D. D’Ambrosia Lectureship & Research Day. 16.
https://digitalscholar.lsuhsc.edu/ortho_rd/2024/presentation2/16
Trochleoplasty in Patellofemoral instability: current concepts
LSUHSC Center for Advanced Learning and Simulation (CALS)
Purpose: Trochlear dysplasia is a significant anatomical and biomechanical risk factor for recurrent patella instability. Trochleoplasty is a surgical procedure that has been described to manage patients with high grade trochlea dysplasia leading to recurrent patella instability. This review aims to describe the current evidence on indications, types of Trochleoplasty, surgical techniques as well as clinical outcomes of Trochleoplasty. Recent findings: Three types of Trochleoplasty that have been described include lateral facet elevation, recession wedge and sulcus deepening Trochleoplasty. The modified Bereiter ‘thin flap’ is the most common type of sulcus deepening procedure which is being performed in recent years compared to the Dejour ‘thick flap’ technique. A recent advancement is the arthroscopic deepening trochleoplasty, which is an arthroscopic variant of the Bereiter technique. In contrast to historical literature, recent studies have reported significant improvement in patient reported outcome measures (PROMs), improved patellofemoral stability and elevated levels of patient satisfaction. Summary: Sulcus deepening Trochleoplasty is a proven technique for management of patients with High grade Trochlear dysplasia associated with patellofemoral instability. It is associated with lower re-dislocation incidence, minimal complication rates, improved clinical outcomes and good patient satisfaction scores. Surgeons managing patellofemoral instability patients should be well versed with the indications and technique of Trochleoplasty.