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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
"arthritis"
symptom
acute rheumatic fever
child syndrome
congenital adrenal hyperplasia
cystinuria
familial hypocalciuric hypercalcemia
familial mediterranean fever
focal myositis
harlequin ichthyosis
homocystinuria without methylmalonic aciduria
inclusion body myositis
lamellar ichthyosis
malignant atrophic papulosis
pyomyositis
sneddon syndrome
trochlear dysplasia
typhoid
wiskott-aldrich syndrome
This symptom has already been validated