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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 2, 180-185.
doi: 10.1302/0301-620X.90B2.20017  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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A prospective evaluation of trochleoplasty for the treatment of patellofemoral dislocation and instability

M. R. Utting, FRCS(Tr&Orth), Specialist Registrar in Trauma and Orthopaedics1; J. S. Mulford, FRACS (Ortho), Consultant Orthopaedic Surgeon2; and J. D. J. Eldridge, FRCS(Tr&Orth), Consultant Orthopaedic Surgeon3

1 Winford Unit, Avon Orthopaedic Centre, Southmead Hospital, Southmead Road, Westbury-on-Trym, Bristol BS10 5BN, UK.
2 Prince of Wales Private Hospital, Barker Street, Randwick, New South Wales, 2031, Australia.
3 Department of Orthopaedics Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, UK.

Correspondence should be sent to Mr M. R. Utting; e-mail: mattutting{at}metronet.co.uk

Trochlear dysplasia is a developmental condition characterised by an abnormally flat or dome-shaped trochlea and is an important contributory factor to patellofemoral instability and recurrent dislocation. We studied prospectively a series of 54 consecutive patients (59 knees) with patellofemoral instability secondary to trochlear dysplasia, who were treated by a trochleoplasty by a single surgeon between June 2002 and June 2007.

Pre- and post-operative scores were assessed by the patients and a satisfaction questionnaire was completed.

Of the 54 patients (59 knees) in the series, 39 (44 knees) were female and 15 (15 knees) were male. Their mean age at surgery was 21 years and 6 months (14 years 4 months to 33 years 11 months). In 40 patients (42 knees) the mean follow-up was for 24 months (12 to 58). One patient was unable to attend for follow-up. An analysis of the results of those patients followed up for at least 12 months showed a statistically significant improvement in outcome (p < 0.001 for all scores). Overall, 50 patients (92.6%) were satisfied with the outcome of their procedure.

The early results of trochleoplasty are encouraging in this challenging group of patients.




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eLetters:

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Trochleoplasty for the treatment of patellofemoral dislocation and instability
Simon T Donell
J Bone Joint Surg Br Online, 16 Apr 2008 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General