Trochleoplasty is the theoretical solution to persistent symptoms (pain and/or instability) related to trochlear\r\ndysplasia where there is not only a trochlear flatness but also a trochlear prominence. The threshold of\r\nprominence indicating surgical intervention has as yet not been determined. A bump of 5 mm is generally\r\naccepted as the inferior limit. Given the interventional nature of this demanding procedure, it should be proposed\r\nin selected cases after considerable discussion with the patient. Trochleoplasty is indicated as a primary procedure\r\nfor major trochlear dysplasia with a prominence > 5 mm. Stabilization is obtained in most of the cases with the\r\nrisk of residual mild anterior knee pain. It is also indicated as a salvage procedure when a previous surgery failed.\r\nDespite the reputation of the procedure, the published results are encouraging in terms of prevention of redislocation,\r\nsatisfaction index, and radiological outcomes. Post-operative stiffness is the main complication, which\r\nmay require manipulation under anaesthesia or arthroscopic arthrolysis. There are few other complications reported\r\nand to date secondary necrosis of the trochlea has not been reported. Technically speaking, the deepening\r\ntrochleoplasty is a difficult procedure without reliable landmarks. We propose a recession wedge trochleoplasty\r\nwhich is an easier procedure. It is never undertaken as an isolated procedure, but always in conjunction with other\r\nrealignment procedures of the extensor apparatus according to the ââ?¬Å?a la carteââ?¬Â surgery concept
Loading....