So You’ve Mastered MPFL Reconstruction: What Else to Add, and When? (AANA22)-Trochleoplasty_ When is it Optimal to Add for Patellar Stabilization

Trochleoplasty_ When is it Optimal to Add for Patellar Stabilization_

Video Transcription

Video Summary

Dr. Liza Arendt discusses trochleoplasty for treating trochlear dysplasia, highlighting patient selection, imaging criteria, and surgical techniques. She explains types of trochleoplasty—thick flap (trochlear osteotomy) and thin flap (arthroscopic)—and emphasizes the importance of identifying a "jumping J sign," ventral supratrochlear prominence over 7mm, and absence of significant patella alta as key surgical indications. Trochlear dysplasia is evaluated mainly via true lateral X-rays, focusing on groove depth, supratrochlear spur, and trochlear length. Dr. Arendt stresses that surgery aims to remove the supratrochlear bump and flatten the trochlear groove rather than deepening it excessively. She notes controversy around performing trochleoplasty with open growth plates but suggests cautious use. Surgical technique involves creating a cartilage flap, preserving the lateral wall, and ensuring flexibility to reposition the groove. Postoperative results show improved trochlear angles with minimal cartilage damage. She concludes by urging surgeons not to disregard the true lateral X-ray for guiding treatment decisions.

Asset Caption

Elizabeth A. Arendt, M.D.

Keywords

trochleoplasty

trochlear dysplasia

jumping J sign

trochlear osteotomy

true lateral X-ray