The arthroscopic deepening trochleoplasty.

Since a dysplastic trochlea has been identified as the main pathomorphology in recurrent patellofemoral instability, trochleoplasty became a surgical solution in some of these cases. However, in comparison to other surgical procedures stabilizing the patellofemoral joint, trochleoplasty is a major operation with an arthrotomy, and associated typical risks of open surgery such as arthrofibrosis. Therefore, we developed a technique to perform an arthroscopic deepening trochleoplasty via suprapatellar portals using shaver burrs. Comparable to the open procedure, a cartilage flake is released and a new bony trochlea is created according to the normal anatomy. Then, the cartilage flake is re-fixated using Vicryl tapes and anchors. This method seems to be an obvious advantage in patellofemoral surgery, since an arthrotomy can be avoided, and postoperative pain as well as soft tissue healing time can be reduced.