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Closing wedge patellar osteotomy in combination with trochleoplasty
Peter P Koch1, Bruno Fuchs, Dominik C Meyer
1Department of Orthopaedic Surgery, University of Zurich, Balgrist, Zurich, Switzerland. peter.koch@balgrist.ch
Acta Orthopaedica Belgica
|April 9, 2011
Summary
Sulcus-deepening trochleoplasty can cause patellofemoral incongruence. A combined closing wedge patellar osteotomy technique improved patellar tracking and congruence in two young patients.
Area of Science:
- Orthopedic Surgery
- Biomechanical Engineering
Background:
- Patellofemoral incongruence is a potential complication of sulcus-deepening trochleoplasty, particularly in patients with highly dysplastic patellae.
- Traditional trochleoplasty techniques may not fully address severe patellar dysplasia, leading to suboptimal outcomes.
Observation:
- A novel surgical approach combining sulcus-deepening trochleoplasty with a closing wedge osteotomy of the patella was performed on two adolescent female patients.
- These patients presented with significant patellar dysplasia and were identified as high-risk for patellofemoral incongruence post-trochleoplasty.
Findings:
- At two-year follow-up, both patients exhibited stable patellar tracking and good patellofemoral congruence.
- Radiographic analysis revealed normalized sulcus angles (135° and 132°), indicating successful correction of trochlear dysplasia.
- Both patients reported excellent functional outcomes and patient satisfaction.
Implications:
- The combined surgical technique effectively addresses severe patellar dysplasia during trochleoplasty.
- This approach offers a viable solution to enhance patellofemoral congruence and improve clinical outcomes in complex cases.
- Further research with larger cohorts is warranted to validate the long-term efficacy of this combined technique.