DOS BULLETIN - Dansk Ortopædisk Selskab

2010-378_DOS nr. 3 2010 29/09/10 10:08 Side 98
The Arthroscopic Trochleoplasty
- A prospective 2 year follow-up
Lars Blønd
Gildhøj Privathospital
Background: The Arthroscopic Trochleoplasty (AT) in combination
with reconstruction of the Medial Patellofemoral Ligament (MPFL) is a
surgical solution for patients with episodic patella dislocation in association
with trochlea dysplasia. The procedure aims to restore normal
anatomy and achieve osseos and ligamentous stability. The AT has been
found to have the usual benefit of minimal invasive surgery compared to
the Open Trochleoplasty.
Purpose: A follow up after combined AT and MPFL reconstruction. No
previous studies has presented results after AT.
Methods: Indications for AT and MPFL reconstruction were 2 or more
patellar dislocations, a persistent apprehension sign from 0 - 30° of flexion
and trochlear dysplasia grade B to D. Exclusion criteria was a cartilage
defect in the trochlea ICRS grade 3 or 4 with a diameter of 5 mm
or more. Tegner, Kujala and KOOS scores have been recorded prospectively.
Eleven consecutive patients (12 knees), 8 women and 3 men with
a median age of 17 (13 – 38) were followed prospectively for an average
of 21 (8- 29) month.
Findings: The preoperative and postoperative median scores were as follows:
Kujula score 67 to 97(53-99), Tegner score 3 to 6(4-8) , KOOS
score: Pain 88 to 100 (53-100), Symptoms 88 to 86(43-100), ACL 96 to
99(78-100), Sports 45 to 95 (30-95), QDL 25 to 66 (19-100). No redislocation
was reported. A negative apprehension sign was found in all
cases. No complications were seen.
Conclusion: This is the first presentation of the results after AT in combination
with MPFL reconstruction. All patient achieved a stable patella.
In regards to the applied kneescores improvement was observed in
respect to all parameters.
98