The Modified Trochleoplasty for Trochlear Dysplasia Types B and D

TL;DR

This paper introduces a new surgical technique for treating severe kneecap instability caused by specific types of trochlear dysplasia.

Contribution

The paper presents a novel modified trochleoplasty technique that simplifies surgery while preserving cartilage and improving patellar stability.

Findings

The modified technique reshapes the trochlear groove without additional osteotomies.

It uses headless compression screws to enhance stability and reduce cartilage damage.

The method is effective for high-grade trochlear dysplasia types B and D.

Abstract

Trochlear dysplasia is a major risk factor for recurrent patellar instability, often requiring surgical intervention in high-grade cases. The present modified trochleoplasty technique, known as the “Brazilian trochleoplasty,” is a reproducible technique developed by the Brazilian Storm Knee Research Group, which reshapes the trochlear groove while preserving cartilage integrity. Our technique is indicated for patients with recurrent patellar dislocation; abnormal patellar tracking, such as the J-sign; and high-grade trochlear dysplasia classified as Dejour types B and D, with trochlear prominence greater than 5 mm. This approach creates a single central sulcus without additional osteotomies, simplifying the procedure while ensuring anatomic precision. Fixation is achieved using headless compression screws, enhancing stability while minimizing cartilage damage. Compared with traditional sulcus-deepening techniques, the modified trochleoplasty offers a more accessible and effective alternative, improving patellar stability and reducing complications such as stiffness. Its stepwise methodology facilitates reproducibility, making it a viable option for young, active patients with severe trochlear dysplasia.

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