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· DOS Abstracts
Clinical outcome of patella stabilizing surgery in-
cluding trochleoplasty for treatment of recurrent
patellar dislocations and severe trochlear dysplasia.
Lene L. Miller, Torsten Grønbech Nielsen, Ole Gade Sørensen, Bjarne Mygind-
Klavsen, Peter Faunø, Martin Lind
Div. Sports Trauma, Orthopedic Dept. , Aarhus University Hospital, Denmark
Background:
Patella instability is highly correlated to trochlea dysplasia (TD).
Severe TD leads to biomechanical and kinematic changes that may require sur-
gical correction in order to obtain successful surgical treatment of patella insta-
bility. Failure after patella stabilizing surgery may be caused by lack of correction
of severe TD.
Purpose / Aim of Study:
The purpose of this present study is to clarify the
effect on patella stability and subjective outcome in patients who had trochleo-
plasty performed as additional procedure to surgical treatment of patella insta-
bility or after failed patella instability surgery.
Materials and Methods:
Twenty-two patients operated between 2013 and
2017 were included in the present study. 3 males and 19 females. Mean age is
24 years (15-41 years). They all had more than 5 dislocations of the patella and
a positive J-sign prior to this operation. 13 patients had one or more previous
unsuccessful patellofemoral surgeries. Trochleoplasty was performed using the
Bereiter technique either open or arthroscopically. Kujala score and Pain numeric
rating scale (NRS) were used to evaluate the effects of intervention.
Findings / Results:
Eight patients (36%) had a trochleoplasty procedure done
bilaterally. 18 patients (82%) had TD Dejour type D, 3 patients 14% type C and
1 patient type B (4%). The procedure was done arthroscopically in 50% of the
patients. The Kujala score increased from 52 preop. to 70 at 1-year follow up.
The NRS score at rest decreased from 3,1 to 1,7 and NRS at exercise decreased
from 5,4 to 3,2. 5 patients (23%) had a reoperation due to arthrofibrosis. None
of the patients had a redislocation of the patella.
Conclusions:
Trochleoplasty is a surgical procedure and should be considered in
the treatment of recurrent patellar dislocation in cases with severe TD and when
previous patellofemoral surgery was unsuccessful.
No conflicts of interest reported
154.