Trochleoplasty Is Associated With High Rates of Patellofemoral Arthritis: A Systematic Review
Cailan L Feingold1, Eric H Lin1, James C Dawahare2
1Department of Orthopaedic Surgery Keck School of Medicine of USC Los Angeles California U.S.A.
Arthroscopy, Sports Medicine, and Rehabilitation
|July 25, 2026
Summary
Trochleoplasty for patellar instability has low recurrence but risks stiffness. Long-term follow-up shows high rates of patellofemoral arthritis, exceeding natural progression.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Sports Medicine
Background:
- Patellofemoral instability is a common orthopedic condition.
- Trochleoplasty is a surgical procedure to address patellofemoral instability.
- Long-term outcomes and complication rates of trochleoplasty require further investigation.
Purpose of the Study:
- To identify 2- to 5-year and >10-year complications of trochleoplasty.
- To define the rates of postoperative patellofemoral arthritis following trochleoplasty.
Main Methods:
- A systematic review of PubMed, Embase, and Web of Science was conducted.
- Included studies were clinical trials on trochleoplasty for patellofemoral instability.
- Studies were grouped by follow-up duration: <2, 2-5, 5-10, and >10 years.
Main Results:
- Thirty-five studies with 1336 patients were analyzed.
- Complication rates ranged from 0% to 33%.
- Patellofemoral arthritis was the most common complication, with rates up to 92% at >10 years, and severe arthritis up to 65%.
Conclusions:
- Trochleoplasty can lead to stiffness, particularly at short-term follow-up.
- Long-term follow-up reveals a high incidence of patellofemoral arthritis after trochleoplasty.
- Complications are more frequent with isolated trochleoplasty compared to procedures with concomitant surgeries.
