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Related Experiment Video

Updated: Nov 16, 2025

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Lateral trochlear lengthening osteotomy.

Petros Ismailidis1,2, Christian Egloff3, Corina Nüesch3,4,5

  • 1Department of Orthopaedics and Traumatology, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland. petrosismailidis@gmail.com.

Archives of Orthopaedic and Trauma Surgery
|February 24, 2021
PubMed
Summary

Lengthening the lateral trochlear ridge improved outcomes for patients with patellofemoral pain and trochlear dysplasia. This surgical technique offers a promising solution for patellar instability and associated knee pain.

Keywords:
Patella instabilityPatellofemoral painTrochlear lengtheningTrochlear osteotomy

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Area of Science:

  • Orthopedic Surgery
  • Biomechanics
  • Knee Joint Anatomy

Background:

  • Patellofemoral pain and instability are often linked to trochlear dysplasia.
  • A short lateral articular trochlea can contribute to these conditions.
  • Surgical intervention may be necessary for recalcitrant cases.

Purpose of the Study:

  • To evaluate the clinical and functional outcomes of lateral trochlear lengthening osteotomy.
  • To describe the indications and technical aspects of this procedure.
  • To assess its efficacy in patients with specific trochlear abnormalities.

Main Methods:

  • A case series of six adult patients undergoing lateral trochlear lengthening osteotomy.
  • Preoperative MRI analysis included trochlear dysplasia classification, Caton-Dechamps index, TT-TG distance, patellar tilt, and lateral condylar index.
  • Clinical outcomes were assessed using Kujala, Lysholm, and Tegner scores, subjective evaluation, and isokinetic strength testing.

Main Results:

  • Four patients had Dejour type A dysplasia; two had no dysplasia.
  • Postoperative scores showed significant improvement: Lysholm (55 to 89), Tegner (3.6 to 5.6), and Kujala (90).
  • Patients reported satisfaction with outcomes, though strength recovery varied.

Conclusions:

  • Lateral trochlear lengthening osteotomy is a viable option for selected patients with trochlear dysplasia or short lateral trochlea.
  • Measuring the lateral condylar index is crucial for surgical planning.
  • The procedure can be performed as an isolated or additional surgery depending on instability severity.