Combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament for patients with recurrent patella dislocation and trochlear dysplasia

PURPOSE: Prospectively, a consecutive group of patients troubled by recurrent patella dislocation and trochlear dysplasia has been followed after a combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament. The purpose of this follow-up study is to report the clinical results. METHODS: Indications for combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament were two or more patellar dislocations with a persistent apprehension sign above 20° of flexion and trochlear dysplasia grade B or more. Prospectively, the Tegner, Kujala and KOOS scores were recorded. Thirty-one consecutive patients (37 knees), 21 women and 10 men, with a median age of 19 (12-39) underwent the procedure. RESULTS: Results were obtained for 29 knees with a minimum of 12-month follow-up (average 29 months; range 12-57). No complications, redislocations or arthrofibrosis have been recorded. Five patients needed further surgery. The median pre- and postoperative scores (range) are as follows: Kujala 64 (12-90) to 95 (47-100); Tegner 4 (1-6) to 6 (4-9); KOOS score pain 86-94; symptoms 82-86; ADL 91-99; sport 40-86; QDL 25-81. No significant correlation was found with respect to the results and recorded parameters. Significant improvement for all of the scores was observed (p<0.001). CONCLUSIONS: The use of arthroscopic deepening trochleoplasty in combination with reconstruction of the medial patellofemoral ligament was found to be a safe and reproducible procedure. Considering the stability achieved, the knee scores and the patient's level of satisfaction, the results are encouraging. LEVEL OF EVIDENCE: Prospective consecutive case series, with evaluation of confounding factor. No control group, Level IV.