Abstract
Introduction: This study assesses the prevalence of trochlear dysplasia as a cause of patello-femoral arthritis (PFOA), though for many years the condition was scarcely recognised and not recorded.
Method: Since 1989 385 primary isolated patello-femoral replacements have been performed in Bristol for patello-femoral arthritis.
The diagnoses recorded were:
Lateral facet PFOA 227
Symmetrical PFOA 95
Medial facet PFOA 24
Dislocation 15
Subluxation 33
Post traumatic 6
Trochlear dysplasia was noted either retrospectively or as “other diagnosis” in only 10 cases between 1989 and 2003, however in the last year, the condition became recognised locally, and has been recorded in 11 of the 48 cases performed.
A recent review of 40 cases aged under 55 showed evidence of causative trochlear dysplasia in more than 50%.
This was based on:
Trochlear dysplasia recorded on operative note 8
A positive crossing sign on a true lateral xray 19
A sulcus angle > 144° 20
Conclusion: Trochlear dysplasia frequently leads to severe symptomatic patello-femoral arthritis, often at an early age, and can be helped by isolated patello-femoral replacement. Since only 38 of the 385 cases had undergone re-alignment procedures it seems likely that the condition initially presents in a variety of ways.
Honorary Secretary – Mr Roger Smith. Correspondence should be addressed to BASK at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN
