Advanced Concepts in Patellofemoral Surgery (AANA22)-When and How to Perform Trochleoplasty

When and How to Perform Trochleoplasty

Video Transcription

Video Summary

David Deduck from the University of Virginia explains trochlear dysplasia diagnosis and treatment, emphasizing lateral x-rays over sunrise views. Key signs include a supratrochlear spur and convex trochlear shape causing patellar instability, often with patella alta or valgus. Trochleoplasty, targeting severe convex spurs over 7mm, reshapes the groove flush with the femoral cortex using thick-shell osteotomy fixed with vicryl sutures. Early motion post-op prevents stiffness. However, trochleoplasty alone doesn't correct bad patellar tracking vectors; combined procedures like MPFL reconstruction and alignment osteotomies may be needed. Proper patient selection and addressing all biomechanical factors are crucial for success.

Asset Caption

David R. Diduch, M.D.

Keywords

trochlear dysplasia

trochleoplasty

patellar instability

MPFL reconstruction

patella alta