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Trochleoplasty in dysplastic knee trochlea.

R Verdonk1, E Jansegers, B Stuyts

  • 1Department of Orthopaedic Surgery and Physical Medicine, Ghent University Hospital, Belgium. rene.verdonk@ugent.be

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|January 13, 2005
PubMed
Summary

Henri Dejour trochleoplasty effectively treats recurrent patellar dislocations and retropatellar pain from trochlear dysplasia. While objective scores were mixed, 77% of patients reported good to very good subjective outcomes, indicating satisfaction with this surgical alternative.

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Area of Science:

  • Orthopedic Surgery
  • Biomechanical Engineering
  • Sports Medicine

Background:

  • Recurrent patellar dislocations and retropatellar pain are often linked to femoral trochlear dysplasia.
  • Dysplasia, characterized by the "crossing sign" on lateral X-rays, can be associated with patella alta.
  • Conservative treatments may be insufficient for severe cases, necessitating surgical intervention.

Purpose of the Study:

  • To evaluate the efficacy of the Henri Dejour trochleoplasty for treating patellar instability and pain caused by trochlear dysplasia.
  • To assess both objective functional outcomes and subjective patient satisfaction following the procedure.

Main Methods:

  • The Henri Dejour trochleoplasty technique involves deepening the femoral trochlea by removing subchondral bone and reshaping the cartilage.
  • 13 procedures were performed on 12 patients between 1996 and 1999.
  • Patient outcomes were assessed using the Larsen-Lauridsen score, evaluating pain, stiffness, crepitus, flexion, and function, alongside radiographic analysis.

Main Results:

  • Strictly lateral X-rays confirmed trochlear dysplasia in all patients, with some exhibiting patella alta.
  • Objective assessment using the Larsen-Lauridsen score resulted predominantly in fair and poor ratings.
  • Subjectively, 77% of patients reported good to very good outcomes, indicating significant satisfaction.

Conclusions:

  • The Henri Dejour trochleoplasty demonstrates potential as a valuable surgical option for managing frank trochlear dysplasia.
  • Despite mixed objective results, the procedure achieves high patient satisfaction rates for persistent retropatellar pain and recurrent patellar dislocations.
  • This technique offers a viable alternative when conservative management fails in cases of significant trochlear abnormalities.