Save
The Outcomes of Trocheoplasty in Patellofemoral Instability: A Systematic Review and Meta-Analysis
ESSKA Academy. Sethi E. May 11, 2018; 218047; FP24-1625
Ervin Sethi
Ervin Sethi
Login now to access Regular content available to all registered users.

You can access free non-premium educational content on the ESSKA Academy Portal by registering for free as 'ESSKA Academy User' here
Abstract
Discussion Forum (0)
Rate & Comment (0)
Objectives: Trochlear dysplasia is one of the commonest causes of patellofemoral instability, affecting 96% of patients with patellofemoral instability. It has also been proven to be one of the predictors of recurrent instability. Trocheoplasty is then developed to improve the outcomes of patients with patellofemoral instability.

This article aims to provide a comprehensive systematic review and meta-analysis to examine the outcomes of trocheoplasty, and the factors affecting these outcomes.

Methods: The review was conducted according to PRISMA guidelines. All studies that reported clinical outcomes before and after trocheoplasty were included in the review. Quantitative random effects meta-analysis was performed to compare between the pre-operative and post-operative outcomes. Meta-regression was employed to identify potential moderators. Articles were evaluated qualitatively when quantitative data were not reported.

Results: A total of 21 publications with 779 knees were included. Surgical indications include recurrent patellar dislocation, high-grade trochlear dysplasia (Dejour B, C and D), lateral patellar glide, positive apprehension test, persistent pain and failed conservative management. Statistically significant improvement in all outcomes was noted post-operatively, including patient satisfaction (RR 46.7; 95% CI: 16.5 - 131.9), Tegner score (1.91; 95% CI: 0.97 - 2.84), Kujula scores (SMD 1.84; 95% CI 1.07 - 2.62), International Knee Documentation Committee score (SMD 1.55; 95% CI 1.16 - 1.94) and Visual Analogue Scale for pain (RR 1.46; 95% CI 0.83 - 1.09). This statistically significant improvement was independent of the other concomitant procedures performed. The patient's age and Dejour's classification for trochlear dysplasia also did not affect the post-surgical outcomes. Complications reported include redislocation, patellofemoral pain, range of motion deficit, arthritis, need for further surgeries including arthroplasty, thromboembolic events and wound infection.

Conclusions: Trocheoplasty is an effective procedure to independently improve the outcomes of patients with patellofemoral instability, regardless of the presence of concomitant procedures as well as the patient's age and classification of trochlear dysplasia.

Keywords:
trochleoplasty; trochlear; trochlea; trochlear dysplasia; trochlea dysplasia; patellofemoral instability; medial patellofemoral ligament; MPFL reconstruction
Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings