Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-47004
Fucentese, S F; Zingg, P O; Schmitt, J; Pfirrmann , C W; Meyer , D C; Koch, P P (2011). Classification of trochlear dysplasia as predictor of clinical outcome after trochleoplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 19(10):1655-1661.
PURPOSE: Sulcus-deepening trochleoplasty restores the trochlear groove in patients with patellofemoral instability and underlying trochlear dysplasia. There are types of dysplasia both with (B and D) and without (A and C) a supratrochlear spur. The aim of this study was to identify influencing factors for the clinical outcome following trochleoplasty.
METHODS: Forty-four knees in 38 patients who underwent trochleoplasty for instability (type A in 9, B in 15, C in 9 and D in 11 knees) were assessed clinically with the Kujala score and radiologically with radiographs and MRI. The median follow-up was 4 (2-7.8) years.
RESULTS: At follow-up, the median Kujala score had improved from 68 (29-84) to 90 (42-100) points (P < 0.001). Instability (P < 0.001) and pain (P = 0.027) decreased significantly, but in 3 knees, pain was worse postoperatively. Twenty-seven knees were ranked as excellent, 10 as good, 2 as fair and 5 as poor. Overall, dysplasia types B and D benefited more from surgery than types A and C. The postoperative MRI revealed no chondrolysis or subchondral necrosis, but deterioration of cartilage on the lateral trochlear facet was identified.
CONCLUSION: Trochleoplasty is a useful and reliable surgical technique to improve patellofemoral instability in patients with a dysplastic trochlea. While improved stability is predictable, pain is less predictable and may even increase following surgery. The overall results were directly dependent on the type of the dysplasia, with a significantly better clinical outcome in type B and D. The clinical relevance of this study is that severe dysplasia can successfully be treated with trochleoplasty.
LEVEL OF EVIDENCE: III.
|Item Type:||Journal Article, refereed, original work|
|Communities & Collections:||04 Faculty of Medicine > University Hospital Zurich > Clinic for Trauma Surgery|
04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
|DDC:||610 Medicine & health|
|Deposited On:||07 Mar 2011 16:42|
|Last Modified:||28 Nov 2013 02:14|
|Citations:||Web of Science®. Times cited: 6|
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