Description of a Trochleoplasty
A trochleoplasty is a rare procedure that is performed in patients that have type B or type D trochlear dysplasia. In these patients, the trochlea can be either flat or dome shaped, which results in severe instability of the patellofemoral joint.
![Trochleoplasty1](https://drrobertlaprademd.com/wp-content/uploads/2015/06/Trochleoplasty1-400x286.jpg)
Image shows Sunrise radiographic views showing the Dejour classification system for trochlear dysplasia: (A) dysplasia type A with a shallow sulcus angle (right knee); (B) dysplasia type C with lateral convexity and medial hypoplasia of the trochlea (left knee).
![Trochleoplasty2](https://drrobertlaprademd.com/wp-content/uploads/2015/06/Trochleoplasty2-400x286.jpg)
(A) The trochleoplasty is performed using a bur to facilitate creation of a decreased sulcus angle; a tap (B) is used to prepare attachment sites for bioabsorbable screws (C), which secure the deepened trochlea as it heals; (D) the completed sulcus-deepening trochleoplasty (left knee).
Are you a candidate for a trochleoplasty procedure?
There are two ways to initiate a consultation with Dr. LaPrade:
You can provide current X-rays and/or MRIs for a clinical case review with Dr. LaPrade.
You can schedule an office consultation with Dr. LaPrade.
(Please keep reading below for more information on this treatment.)
Trochleoplasty Procedure
A trochleoplasty is performed by reshaping the distal aspect of the femur. In this circumstance, guide pins are placed along the undersurface of the trochlea cartilage surface and a saw is used to undermine the articular cartilage. A V-shaped groove is then prepared in the distal femur, and the articular cartilage is positioned down into the V to reconstitute the bony groove. A trochleoplasty is rarely performed as a primary procedure, and most often is performed after patients have failed other types of reconstructions, including a MPFL reconstruction. Because of the complex nature of these problems, a trochleoplasty can also be commonly performed with a distal femoral osteotomy, a medial patellofemoral ligament reconstruction and/or a tibial tubercle osteotomy.
For this reason, the patient needs a thorough clinical exam, radiographic work up, and evaluation of the status of the articular cartilage prior to undergoing a trochleoplasty to obtain the best chance of an optimal outcome.
Dr. LaPrade published a study about Trochleoplasty and it can be found HERE