Morphological Changes in Femoral Trochlea After Extensor Realignment Surgery in Children With Congenital Patellar...

Area of Science:

• Pediatric Orthopedics
• Biomechanical Engineering
• Radiology

Background:

• Femoral trochlear dysplasia (FTD) is a primary cause of knee instability.
• Congenital patellar dislocation (CPD) often co-occurs with distal FTD.
• Limited research exists on trochlear development post-surgery in skeletally immature individuals.

Purpose of the Study:

• To evaluate trochlear remodeling after surgical extensor realignment and stabilization in pediatric CPD.
• To identify factors influencing trochlear remodeling in these patients.

Main Methods:

• Retrospective analysis of 58 pediatric CPD cases (80 knees) across two centers (2014-2023).
• Data included patient demographics, syndromic status, MRI-derived trochlear indices (TDI, LTI, MCTO), and pre/postoperative range of motion and Lysholm scores.
• Surgical techniques involved lateral retinacular release, medial capsule resection, quadriceps lengthening, and Roux-Goldthwait procedure.

Main Results:

• Significant improvements in pre- to postoperative trochlear depth index (TDI), medial condylar trochlear offset (MCTO), and lateral trochlear inclination (LTI) (P < .0001).
• Low patellar redislocation rate (1.7%) with excellent functional outcomes (full knee motion, mean Lysholm score of 96).
• Mean follow-up of 2.46 years in pediatric patients aged 14-64 months.

Conclusions:

• Surgical intervention can promote trochlear remodeling in skeletally immature patients with CPD.
• The study demonstrates the potential for improved knee joint stability and function following surgical correction.