Trochleoplasty With Combined Soft Tissue Reconstruction for Patellar Instability

Background: Patellofemoral instability is a relatively common condition and is multifactorial in its cause, with both soft tissue and bony components. Trochleoplasty is a newly described surgical procedure to help improve outcomes following patellar restabilization. Indications: Trochleoplasty is an...

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Main Authors: Steven Magister MD, Jose Perez MD, Charles Lin MD, Dylan Lowe MD, James L. Pace MD, Laith Jazrawi MD
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:Video Journal of Sports Medicine
Online Access:https://doi.org/10.1177/26350254241310257
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author Steven Magister MD
Jose Perez MD
Charles Lin MD
Dylan Lowe MD
James L. Pace MD
Laith Jazrawi MD
author_facet Steven Magister MD
Jose Perez MD
Charles Lin MD
Dylan Lowe MD
James L. Pace MD
Laith Jazrawi MD
author_sort Steven Magister MD
collection DOAJ
description Background: Patellofemoral instability is a relatively common condition and is multifactorial in its cause, with both soft tissue and bony components. Trochleoplasty is a newly described surgical procedure to help improve outcomes following patellar restabilization. Indications: Trochleoplasty is an emerging surgical technique during patellar stabilization surgery in those patients with underlying trochlear dysplasia. Technique Description: Trochleoplasty was performed via an open medial parapatellar arthrotomy. Using a combination of osteotome and guided bur, the subchondral surface was undermined to produce a deeper sulcus. The cartilage surface was then plastically deformed into the newly developed trochlea. Trochleoplasty was then secured with a central triple-loaded interference screw and 3 peripheral interference screws. Medial patellofemoral ligament reconstruction was then performed in standard fashion. Results: Postoperative course was complicated by arthrofibrosis, which required manipulation at 4 weeks. Following manipulation, the patient recovered uneventfully and had returned to full activities at 6 months with full strength, range of motion, and minimal pain. Discussion/Conclusion: Trochleoplasty with combined soft tissue reconstruction is a viable treatment option in those patients with recurrent patellar instability and underlying trochlear dysplasia. While not without complications, this surgical technique remains a powerful tool in the correctly indicated patient. Appropriate patient selection and adherence to postoperative rehabilitation are crucial for optimal outcomes. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
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spelling doaj-art-b559f92d5c714772a8b14bfab01fdb9a2025-08-20T02:23:26ZengSAGE PublishingVideo Journal of Sports Medicine2635-02542025-06-01510.1177/26350254241310257Trochleoplasty With Combined Soft Tissue Reconstruction for Patellar InstabilitySteven Magister MD0Jose Perez MD1Charles Lin MD2Dylan Lowe MD3James L. Pace MD4Laith Jazrawi MD5Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York, USADepartment of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York, USADepartment of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York, USADepartment of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York, USADepartment of Orthopaedic Surgery, Children's Health, Plano, Texas, USADepartment of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York, USABackground: Patellofemoral instability is a relatively common condition and is multifactorial in its cause, with both soft tissue and bony components. Trochleoplasty is a newly described surgical procedure to help improve outcomes following patellar restabilization. Indications: Trochleoplasty is an emerging surgical technique during patellar stabilization surgery in those patients with underlying trochlear dysplasia. Technique Description: Trochleoplasty was performed via an open medial parapatellar arthrotomy. Using a combination of osteotome and guided bur, the subchondral surface was undermined to produce a deeper sulcus. The cartilage surface was then plastically deformed into the newly developed trochlea. Trochleoplasty was then secured with a central triple-loaded interference screw and 3 peripheral interference screws. Medial patellofemoral ligament reconstruction was then performed in standard fashion. Results: Postoperative course was complicated by arthrofibrosis, which required manipulation at 4 weeks. Following manipulation, the patient recovered uneventfully and had returned to full activities at 6 months with full strength, range of motion, and minimal pain. Discussion/Conclusion: Trochleoplasty with combined soft tissue reconstruction is a viable treatment option in those patients with recurrent patellar instability and underlying trochlear dysplasia. While not without complications, this surgical technique remains a powerful tool in the correctly indicated patient. Appropriate patient selection and adherence to postoperative rehabilitation are crucial for optimal outcomes. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.https://doi.org/10.1177/26350254241310257
spellingShingle Steven Magister MD
Jose Perez MD
Charles Lin MD
Dylan Lowe MD
James L. Pace MD
Laith Jazrawi MD
Trochleoplasty With Combined Soft Tissue Reconstruction for Patellar Instability
Video Journal of Sports Medicine
title Trochleoplasty With Combined Soft Tissue Reconstruction for Patellar Instability
title_full Trochleoplasty With Combined Soft Tissue Reconstruction for Patellar Instability
title_fullStr Trochleoplasty With Combined Soft Tissue Reconstruction for Patellar Instability
title_full_unstemmed Trochleoplasty With Combined Soft Tissue Reconstruction for Patellar Instability
title_short Trochleoplasty With Combined Soft Tissue Reconstruction for Patellar Instability
title_sort trochleoplasty with combined soft tissue reconstruction for patellar instability
url https://doi.org/10.1177/26350254241310257
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