Abstract
Introduction: The purpose was to present a new osteotomy technique (trochleoplasty) and its preliminary results for the treatment of femoral trochlear dysplasia with recurrent patellar dislocation.
Methods: Between 1990 and 2002, 59 knees of 51 patients (mean age 224 years) with recurrent patellar dislocation due to femoral trochlear dysplasia were treated uniformly at a single institution with a new osteotomy technique developed by the senior author. A distally connected osteochondral flake is released from the dysplastic trochlea and refixed after the osseous trochlear groove has been reconstructed. 44 patients with 50 involved knees returned at a mean follow-up of 37 months (range 6 to 139) for a physical examination, assessment of knee pain and function, radiographic examination of the knee, and in selectived cases for CT scan, MR imaging and follow-up knee arthroscopy.
Results: Postoperative complications were limited to hemarthros-1, arthrofibrosis-1, and sudeck‘s disease-1. Postoperatively, no further patellar dislocations were reported. All patients experienced a sensation of significantly improved knee stability resulting in higher levels of activity. Retropatellar pain as found in 34 knees preoperatively was better-24, unchanged-7, worse-6 (3 additional cases) after surgery. Positive apprehension sign, as preoperatively found in all patients, turned negative in all cases. Radiographically, osseous healing of the reconstructed trochlea was noted without evidence of subsequent arthrosis. MRI and knee arthroscopy including histological analysis of osteochondral biopsies did not provide any evidence for osteonecrosis or chondropathia.
Conclusion: Recurrent patellar dislocation due to femoral trochlear dysplasia can be treated successfully using the presented technique of trochleoplasty.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
