So, You’ve Mastered MPFL Reconstruction: What Else to Add, and When? (2021 Annual Meeting)-So You’ve Mastered MPFL Reconstruction: What Else to Add, and When?-Arendt

So You’ve Mastered MPFL Reconstruction: What Else to Add, and When?-Arendt

Video Transcription

Video Summary

The speaker discusses trochleoplasties, focusing on deepening trochleoplasty techniques for treating high-grade trochlear dysplasia—a major cause of patellar instability. There are two main types: thick flap osteotomy (popularized by Lyon School) and thin flap trochleoplasty (initiated by Baradar), with both open and arthroscopic methods. Patient selection hinges on imaging findings such as a prominent J sign, supratrochlear spur, crossing and double contour signs, and the "cliff sign," indicating severe dysplasia. The decision to perform trochleoplasty over other procedures like distalizing osteotomy depends on factors like trochlear depth and length, patella alta, and cartilage condition. The surgical procedure involves removing the supratrochlear spur, creating a groove while preserving the lateral trochlear wall, and fixing the flap with absorbable sutures. Despite technical challenges, trochleoplasty offers improved patellar tracking and stability for select patients and should be part of the patellofemoral surgeon’s toolkit. Understanding and recognizing trochlear dysplasia is key for appropriate referral and treatment planning.

Asset Caption

Dr. Elizabeth Arendt

Keywords

trochleoplasty

trochlear dysplasia

patellar instability

deepening trochleoplasty techniques

patellofemoral surgery