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Trochleoplasty provides good clinical outcomes and an acceptable complication profile in both short and long-term follow-up

  • Laurie A. HiemstraEmail author
  • Devin Peterson
  • Michael Youssef
  • John Soliman
  • Laura Banfield
  • Olufemi R. Ayeni
KNEE
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Abstract

Purpose

The purpose of this study is to report on the global distribution and clinical outcomes of published articles related to trochleoplasty.

Methods

The online databases OVID Medline, OVID EMBASE, and the Cochrane Library were searched for the literature assessing trochleoplasty performed for lateral patellofemoral instability (LPI). Study data were abstracted looking at global trends in the literature, as well as clinical and patient-reported outcomes following this technique.

Results

For the assessment of global distribution, 29 studies including 998 patients met the inclusion criteria. The majority of the studies were conducted in Europe (93%) and most used an open thin flap technique (52%). For the secondary analysis of clinical outcomes, 21 studies were included with significant heterogeneity in patient selection, reporting on the degree of trochlear dysplasia, and patient-reported outcomes. All trochleoplasty techniques showed statistically significant improvement in clinical outcomes at average 50 months (range 3–228 months) post-operative, with most patients being satisfied with their procedure. Re-dislocation and complication rates were low.

Conclusions

European centers have published majority of data on trochleoplasty surgery, which has been shown to be an acceptable procedure for patients with high-grade trochlear dysplasia and LPI. Trochleoplasty has demonstrated good clinical outcomes, a low re-dislocation rate, and an acceptable complication profile in both short and long-term follow-up. This study highlights the difficulty in reporting outcomes in this group of patients due to heterogeneity in patient selection, grading of trochlear dysplasia, and the lack of disease-specific outcome measures.

Level of evidence

IV.

Keywords

Trochleoplasty Trochlear dysplasia Lateral patellar instability Patella Outcomes Complications Osteoarthritis Medial patellofemoral ligament MPFL 

Abbreviations

LPI

Lateral patellofemoral instability

MPFL

Medial patellofemoral ligament

TTO

Tibial tubercle osteotomy

LR

Lateral release

PROM

Patient-reported outcome measure

OA

Osteoarthritis

Notes

Funding

No funding was received for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  • Laurie A. Hiemstra
    • 1
    • 2
    Email author
  • Devin Peterson
    • 3
  • Michael Youssef
    • 5
  • John Soliman
    • 4
  • Laura Banfield
    • 4
  • Olufemi R. Ayeni
    • 3
  1. 1.Banff Sport MedicineBanffCanada
  2. 2.Department of SurgeryUniversity of CalgaryCalgaryCanada
  3. 3.Division of Orthopaedic Surgery, Department SurgeryMcMaster UniversityHamiltonCanada
  4. 4.Faculty of Health SciencesMcMaster UniversityHamiltonCanada
  5. 5.Faculty of MedicineUniversity of TorontoTorontoCanada

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