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Reconstructive surgery for patellofemoral joint incongruency.
[trochlear dysplasia]
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
.
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
)
.
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
.
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
.
