Magister Steven, Perez Jose, Lin Charles, Lowe Dylan, Pace James L, Jazrawi Laith
Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York, USA.
Department of Orthopaedic Surgery, Children's Health, Plano, Texas, USA.
Video J Sports Med. 2025 Jun 10;5(3):26350254241310257. doi: 10.1177/26350254241310257. eCollection 2025 May-Jun.
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.
Trochleoplasty is an emerging surgical technique during patellar stabilization surgery in those patients with underlying trochlear dysplasia.
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.
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.
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.
髌股关节不稳是一种相对常见的病症，其病因是多因素的，包括软组织和骨骼成分。滑车成形术是一种新描述的外科手术，有助于改善髌骨重新稳定后的治疗效果。
滑车成形术是一种在患有潜在滑车发育不良的患者进行髌骨稳定手术时新兴的外科技术。
滑车成形术通过开放的内侧髌旁关节切开术进行。使用骨凿和导向磨钻相结合的方法，对软骨下表面进行潜行剥离以形成更深的沟。然后将软骨表面塑性变形为新形成的滑车。接着用中央三负荷加压空心钉和3枚周边加压空心钉固定滑车成形术。然后以标准方式进行内侧髌股韧带重建。
术后病程因关节纤维化而复杂化，这需要在4周时进行手法治疗。手法治疗后，患者恢复顺利，6个月时已恢复全部活动，力量、活动范围完全恢复，疼痛轻微。
讨论/结论：联合软组织重建的滑车成形术是复发性髌股关节不稳且伴有潜在滑车发育不良患者的一种可行治疗选择。虽然并非没有并发症，但这种外科技术仍然是适合患者的有力工具。正确选择患者并坚持术后康复对于获得最佳效果至关重要。
作者证明已获得本出版物中出现的任何患者的同意。如果个体可能被识别，作者已随本稿件提交包含患者发布声明或其他书面批准形式以供发表。
