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Patellar Instability

When is Trochleoplasty Necessary?

Carstensen, S. Evan MD; Menzer, Heather M. MD; Diduch, David R. MD

Sports Medicine and Arthroscopy Review: June 2017 - Volume 25 - Issue 2 - p 92–99
doi: 10.1097/JSA.0000000000000150
Review Articles

Trochleoplasty is a very effective procedure for correcting trochlear dysplasia and addressing instability of the patella. With an increasing knowledge about the anatomy and biomechanics of the anterior distal femur, a wider array of surgical techniques may be applied to address specific conditions. Patients must be carefully selected to undergo trochleoplasty by use of a thorough history and physical examination as well as basic and advanced imaging. The presence of a “J sign” on physical examination, a history of recurrent instability, patella alta, trochlear dysplasia, and elevated tibial tubercle to trochlear groove are signs and symptoms for which the patient should be evaluated. We attempt to elucidate when trochleoplasty is indicated by means of addressing all aspects of evaluation.

Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA

Disclosure: The authors declare no conflict of interest.

Reprints: David R. Diduch, MD, Department of Orthopaedic Surgery, University of Virginia Health System, P.O. Box 800159, Charlottesville, VA 22908.

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.