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The Lyon's sulcus-deepening trochleoplasty in previous unsuccessful patellofemoral surgery.
[trochlear dysplasia]
Trochleoplasty
is
a
relatively
rare
operation
with
few
published
results
and
it
remains
a
technically
demanding
procedure
which
requires
careful
patient
selection
.
The
ideal
candidate
for
surgery
remains
to
be
elucidated
,
and
some
authors
consider
it
as
a
good
revision
option
in
cases
of
previous
unsuccessful
operations
for
persisting
patellar
dislocation
with
underlying
trochlear
dysplasia
.
The
purpose
of
this
study
is
to
record
the
results
from
the
application
of
sulcus-deepening
trochleoplasty
in
patients
with
trochlear
dysplasia
and
previous
unsuccessful
surgery
for
patellar
dislocation
.
Twenty
-
two
patients
(
24
knees
)
were
operated
upon
during
the
period
9
/
1993
-
9
/
2006
;
they
had
undergone
surgery
for
patellofemoral
instability
and
had
persistent
patellar
dislocation
,
and
were
followed-up
for
a
mean
of
66
months
(
24
-
191
)
.
Trochleoplasty
was
performed
in
all
patients
using
the
same
technique
and
rehabilitation
protocol
.
Additional
soft
-tissue
and
bony
operations
were
performed
in
every
case
.
Of
all
cases
,
29
.
1
%
had
type
B
and
70
.
9
%
had
type
D
trochlear
dysplasia
.
After
trochleoplasty
,
no
patient
had
a
patellar
re
-
dislocation
up
to
the
last
follow-up
.
Pain
decreased
in
72
%
and
the
apprehension
sign
was
negative
in
75
%
of
the
cases
(
p
 
<
 
0
.
01
)
.
Sulcus
angle
decreased
from
153
°
 
±
 
14
°
to
141
°
 
±
 
10
°
(
p
 
<
 
0
.
01
)
,
TT-
TG
distance
decreased
from
16
 
±
 
6
mm
to
12
 
±
 
2
mm
(
p
 
<
 
0
.
001
)
,
and
patellar
tilt
decreased
from
31
°
 
±
 
14
°
to
11
°
 
±
 
8
°
(
p
 
<
 
0
.
0001
)
.
Mean
pre-operative
Kujala
score
was
44
(
25
-
73
)
and
at
the
latest
follow-up
it
increased
to
81
(
53
-
100
)
,
(
p
 
<
 
0
.
001
)
.
At
the
time
of
final
follow-up
,
there
was
no
case
of
patellofemoral
arthritis
.
Trochlear
dysplasia
is
a
key
factor
in
the
treatment
of
recurrent
patellar
dislocation
and
its
correction
could
be
included
in
the
surgical
options
.
Sulcus-deepening
trochleoplasty
is
an
acceptable
revision
option
for
the
surgical
treatment
of
patients
with
persisting
patellar
dislocation
and
high
-grade
trochlear
dysplasia
.
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