Combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament for patients with recurrent patella dislocation and trochlear dysplasia

Abstract

Purpose

Prospectively, a consecutive group of patients troubled by recurrent patella dislocation and trochlear dysplasia has been followed after a combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament. The purpose of this follow-up study is to report the clinical results.

Methods

Indications for combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament were two or more patellar dislocations with a persistent apprehension sign above 20° of flexion and trochlear dysplasia grade B or more. Prospectively, the Tegner, Kujala and KOOS scores were recorded. Thirty-one consecutive patients (37 knees), 21 women and 10 men, with a median age of 19 (12–39) underwent the procedure.

Results

Results were obtained for 29 knees with a minimum of 12-month follow-up (average 29 months; range 12–57). No complications, redislocations or arthrofibrosis have been recorded. Five patients needed further surgery. The median pre- and postoperative scores (range) are as follows: Kujala 64 (12–90) to 95 (47–100); Tegner 4 (1–6) to 6 (4–9); KOOS score pain 86–94; symptoms 82–86; ADL 91–99; sport 40–86; QDL 25–81. No significant correlation was found with respect to the results and recorded parameters. Significant improvement for all of the scores was observed (p < 0.001).

Conclusions

The use of arthroscopic deepening trochleoplasty in combination with reconstruction of the medial patellofemoral ligament was found to be a safe and reproducible procedure. Considering the stability achieved, the knee scores and the patient’s level of satisfaction, the results are encouraging.

Level of evidence

Prospective consecutive case series, with evaluation of confounding factor. No control group, Level IV.

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Correspondence to Lars Blønd.

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Blønd, L., Haugegaard, M. Combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament for patients with recurrent patella dislocation and trochlear dysplasia. Knee Surg Sports Traumatol Arthrosc 22, 2484–2490 (2014). https://doi.org/10.1007/s00167-013-2422-2

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Keywords

  • Patella instability
  • Trochlear dysplasia
  • Patellofemoral
  • Patellar dislocation
  • Knee
  • Trochleoplasty
  • Medial patellofemoral reconstruction