A trochleoplasty is a surgical procedure to re-shape the walls of the trochlear groove to improve patellar stability.

Page updated June 2024 by Dr Sheila Strover (Clinical Editor)

trochlear dysplasia

Illustration of a section through the upper femoral trochlea showing a shallow groove of mild trochlear dysplasia predisposing to episodes of subluxation and dislocation of the patella.

sulcus-deepening trochleoplasty

The same view after a 'sulcus-deepening' trochleoplasty, where a wedge of underlying bone is removed to help re-shape the walls of the groove and contain the patella.

 

Trochlear dysplasia and patellar instability

A flat or even dome-shaped upper trochlear groove (trochlear dysplasia) may fail to contain the patella when the leg is straight, and during early bending of the knee it may slip over to the side - subluxing or even dislocating.

This is particularly so when the abnormal upper trochlea is associated with a higher than normal patella - patella alta. When the situation is extreme, trochleoplasty may be offered to try to steepen the trochlear groove.

 

  • Quote from peer-reviewed paper:

    "....trochleoplasty can reliably improve patellofemoral stability in patients with severe trochlear dysplasia, but a high percentage of patients will have pain postoperatively"

    Citation: Faruqui S, Bollier M, Wolf B, Amendola N. Outcomes after trochleoplasty. Iowa Orthop J. 2012;32:196-206. PMID: 23576941; PMCID: PMC3565402.

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How is trochleoplasty performed?

Trochleoplasty is generally only performed by specialist patellofemoral surgeons, who have good experience in managing kneecap instability.

There are several different surgical techniques of trochleoplasty:

In addition to the trochleoplasty, the surgeon is likely to reconstruct any lax MPFL (medial patellofemoral ligament) or do a medial 'imbrication' to tighten up the tissues on the medial side of the patella.

 

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Dr Sheila Strover (Editor)
BSc (Hons), MB BCh, MBA

See biography...


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VIDEO: Kneecap instability and trochlear dysplasia