Offset-Reducing and Sulcus-Deepening Trochleoplasty for the Combined Treatment of Patellar Instability and Anterior...

Trochlear dysplasia is one of the most important factors that influences the biomechanics of the patellofemoral (PF) joint. In cases of PF instability, trochlear dysplasia is associated with a significant increase in the risk of redislocation. Furthermore, it is considered one of the most relevant independent risk factors for the development of PF cartilage lesions and anterior knee pain. In PF instability, trochleoplasty is a well-established procedure, providing good to excellent functional outcomes, as well as a low redislocation risk in the mid- to long-term. However, reliable scientific evidence for TP in the treatment of anterior knee pain is scarce. This is particularly true in cases of increased anterior trochlear offset. The presented technique combines sulcus-deepening and offset-reducing TP to treat PF instability and anterior knee pain in the presence of a grade IV retropatellar cartilage lesion, using Vicryl sutures for the fixation of the osteochondral flap.