Reconstructive Surgery for Patellofemoral Joint Incongruency

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2014 Nov 1

PMID 25358690

Citations 11

Authors

M V Neumann

M Stalder

A J Schuster

Affiliations

Soon will be listed here.

Abstract

Purpose: A retrospective analysis of a heterogeneous patient cohort was performed to determine the outcome and eligibility of a combined trochleaplasty and soft tissue-balancing technique for repair of patellofemoral joint disorders.

Methods: A strict surgical treatment algorithm including trochleaplasty and reconstruction of the medial patellofemoral ligament and vastus medialis oblique muscle was implemented to restore the patellofemoral joint. A heterogeneous patient cohort including 46 consecutively treated symptomatic knees was reviewed. The median follow-up period was 4.7 years (range 24-109 months).

Results: No patellar redislocation occurred post-operatively, and the median Kujala score improved from 62 (9-96) to 88 (47-100) points (p < 0.001) at follow-up. Radiological signs of trochlear dysplasia were corrected, and both patellar height and trochlear depth were significantly restored after surgery. In total, 16% of affected patients with pre-existing patellofemoral degenerative changes showed progression of osteoarthrosis according to the Kellgren and Lawrence classification.

Conclusion: The surgical combination of trochleaplasty and reconstruction of the medial patellofemoral ligament and vastus medialis oblique muscle offers excellent clinical and radiological results. The overall results of the present study showed significant improvement of the Kujala score in patients with Dejour grades C and D dysplasia. These results outline the clinical relevance of trochleaplasty with additional soft tissue balancing as an effective joint-preserving method with satisfying results in patients with pre-existing degenerative changes.

Level Of Evidence: IV.

Citing Articles

Rehabilitation after surgery for patellar instability.

Hysing-Dahl T, Inderhaug E J Exp Orthop. 2024; 11(3):e12062.

PMID: 38887658 PMC: 11180699. DOI: 10.1002/jeo2.12062.

Trochleoplasty Provides Good Outcomes for Recurrent Patellofemoral Dislocations with No Clear Superiority across Different Techniques.

Tan S, Law G, Kim S, Sethi E, Lim A, Hui J J Clin Med. 2024; 13(10).

PMID: 38792556 PMC: 11122057. DOI: 10.3390/jcm13103009.

[Reality of care of patella stabilizing operations : A status quo among active members of the German Society for Orthopedic and Trauma Surgery (DGOU)].

Fuchs A, Frodl A, Yilmaz T, Feucht M, Hoffmann R, Dickschas J Orthopadie (Heidelb). 2022; 51(8):652-659.

PMID: 35925283 PMC: 9352640. DOI: 10.1007/s00132-022-04264-3.

Are Patellofemoral Ligaments and Retinacula Distinct Structures of the Knee Joint? An Anatomic, Histological and Magnetic Resonance Imaging Study.

Biz C, Stecco C, Crimi A, Pirri C, Fosser M, Fede C Int J Environ Res Public Health. 2022; 19(3).

PMID: 35162134 PMC: 8834464. DOI: 10.3390/ijerph19031110.

Clinical outcomes and predictive factors for failure with MPFL reconstruction combined with tibial tubercle osteotomy and lateral retinacular release for recurrent patellar instability.

Su P, Liu X, Jian N, Li J, Fu W BMC Musculoskelet Disord. 2021; 22(1):632.

PMID: 34289826 PMC: 8296593. DOI: 10.1186/s12891-021-04508-x.

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