The dysplastic trochlear is a developmental condition characterized by an abnormally flat or dome-shaped trochlea and it is recognized as a significant cause of patella instability. Surgical correction of the shape of the Trochlear Groove is frequently performed. The described methods in the literature involve open arthrotomy to normalize and maintain the trochlear morphology achieving normal alignment and tracking of the patella. Open procedures carries a significant risk of arthrofibrosis. We describe an arthroscopic procedure to create a neo-trochlea using gouges, spherical and conical hooded burrs. We studied prospectively a series of 4 consecutive patients with patello-femoral instability secondary to trochlear dysplasia, who were treated by an Arthroscopic trochleoplasty by a single surgeon between 2007 and 2008. Postoperatively the patients were rehabilitated in accordance with our routine Patello-Femoral microfracture protocol. CT scanning at one year showed a complete neo-cortex and cartilage sequenced MRI at 12 months showed complete fill with fibro cartilage. Pre- and post-operative scores (KOOS, Kujala) were assessed by the patients and a satisfaction questionnaire was completed. The results showed a statistical improvement in the outcome at the 3 year follow up.Introduction
Material, methods and results
