Paolo Ferrua1, Riccardo Compagnoni1, Filippo Calanna2, Pietro Simone Randelli1,3, David Dejour4. 1. 1^ Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy. 2. 1^ Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy. filippocalanna@gmail.com. 3. Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Piazza Cardinal Ferrari 1, 20122, Milan, Italy. 4. Department of Orthopaedics, Lyon-Ortho-Clinic, Clinique de la Sauvegarde, Lyon, France.
Abstract
PURPOSE: Trochlear dysplasia has been recognized as the most common factor in patients with patellofemoral dislocation. Trochleoplasty is a surgical procedure whose primary goal is to modify the femoral trochlea's abnormal shape in patients suffering from patellar instability, requiring good surgical skills, correct indication, and accurate patient information. METHODS: The review aims to describe preoperative planning, patient selection, most common surgical techniques, and clinical results of trochleoplasty in patellar instability in a reproducible manner. RESULTS: Trochleoplasty can be considered a general term to describe a group of different procedures that reduce trochlear dysplasia's impact on patellar instability, aiming to restore patella-trochlear congruency, remove the supratrochlear bump, allowed a new groove positioning and are generally associated with other procedures. Recent studies showed satisfactory long-term results with the restoration of patellar stability, improving radiological findings of patellofemoral instability. CONCLUSION: Trochleoplasty is a technically demanding technique, requiring careful patient selection, detailed knowledge, and surgical skills to avoid severe complications. Good patient satisfaction with a low risk of significant complications such as patellofemoral arthritis has been revealed. In conclusion, trochleoplasty should be systematically included in the treatment of patellar dislocation, if indicated. LEVEL OF EVIDENCE: V.
PURPOSE: Trochlear dysplasia has been recognized as the most common factor in patients with patellofemoral dislocation. Trochleoplasty is a surgical procedure whose primary goal is to modify the femoral trochlea's abnormal shape in patients suffering from patellar instability, requiring good surgical skills, correct indication, and accurate patient information. METHODS: The review aims to describe preoperative planning, patient selection, most common surgical techniques, and clinical results of trochleoplasty in patellar instability in a reproducible manner. RESULTS: Trochleoplasty can be considered a general term to describe a group of different procedures that reduce trochlear dysplasia's impact on patellar instability, aiming to restore patella-trochlear congruency, remove the supratrochlear bump, allowed a new groove positioning and are generally associated with other procedures. Recent studies showed satisfactory long-term results with the restoration of patellar stability, improving radiological findings of patellofemoral instability. CONCLUSION: Trochleoplasty is a technically demanding technique, requiring careful patient selection, detailed knowledge, and surgical skills to avoid severe complications. Good patient satisfaction with a low risk of significant complications such as patellofemoral arthritis has been revealed. In conclusion, trochleoplasty should be systematically included in the treatment of patellar dislocation, if indicated. LEVEL OF EVIDENCE: V.
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