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Combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament for patients with recurrent patella dislocation and trochlear dysplasia.
[trochlear dysplasia]
Prospectively
,
a
consecutive
group
of
patients
troubled
by
recurrent
patella
dislocation
and
trochlear
dysplasia
has
been
followed
after
a
combined
arthroscopic
deepening
trochleoplasty
and
reconstruction
of
the
medial
patellofemoral
ligament
.
The
purpose
of
this
follow-up
study
is
to
report
the
clinical
results
.
Indications
for
combined
arthroscopic
deepening
trochleoplasty
and
reconstruction
of
the
medial
patellofemoral
ligament
were
two
or
more
patellar
dislocations
with
a
persistent
apprehension
sign
above
20
°
of
flexion
and
trochlear
dysplasia
grade
B
or
more
.
Prospectively
,
the
Tegner
,
Kujala
and
KOOS
scores
were
recorded
.
Thirty
-
one
consecutive
patients
(
37
knees
)
,
21
women
and
10
men
,
with
a
median
age
of
19
(
12
-
39
)
underwent
the
procedure
.
Results
were
obtained
for
29
knees
with
a
minimum
of
12
-
month
follow-up
(
average
29
months
;
range
12
-
57
)
.
No
complications
,
redislocations
or
arthrofibrosis
have
been
recorded
.
Five
patients
needed
further
surgery
.
The
median
pre-
and
postoperative
scores
(
range
)
are
as
follows
:
Kujala
64
(
12
-
90
)
to
95
(
47
-
100
)
;
Tegner
4
(
1
-
6
)
to
6
(
4
-
9
)
;
KOOS
score
pain
86
-
94
;
symptoms
82
-
86
;
ADL
91
-
99
;
sport
40
-
86
;
QDL
25
-
81
.
No
significant
correlation
was
found
with
respect
to
the
results
and
recorded
parameters
.
Significant
improvement
for
all
of
the
scores
was
observed
(
p
<
0
.
001
)
.
The
use
of
arthroscopic
deepening
trochleoplasty
in
combination
with
reconstruction
of
the
medial
patellofemoral
ligament
was
found
to
be
a
safe
and
reproducible
procedure
.
Considering
the
stability
achieved
,
the
knee
scores
and
the
patient
's
level
of
satisfaction
,
the
results
are
encouraging
.
Prospective
consecutive
case
series
,
with
evaluation
of
confounding
factor
.
No
control
group
,
Level
IV
.
Diseases
Validation
Diseases presenting
"pain"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
aniridia
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
pleomorphic liposarcoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
trochlear dysplasia
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wolf-hirschhorn syndrome
This symptom has already been validated