gms | German Medical Science

Objectives: Patellar instability has a high incidence, especially in the young and female populations. Trochlear dysplasia with a flat or convex patellar groove (Trochlear dysplasia Type B, C, or D according to Dejour) plays a crucial role as a predisposing factor. In these cases, operative realignment, known as Trochleoplasty/Trochlear osteotomy, is considered. Our Department has been dealing with the treatment of instabilities and dislocations in the femoropatellar joint since 2010. The aim of the study is to systematically evaluate the Trochleoplasty of patients treated in between 2010 and 2022, in order to assess the method used and its quality compared to other centers and their results. In summary, the aim was to pursue quality control for the treatment approach.

Methods: The study was conducted as a combination of retrospective data evaluation and prospective data collection of the study population. For the PROM (Patient-Reported Outcome Measures), the following study instruments were used: Kujala Score, BP II 2.0, SF-12 Score, MARX Activity Rating Scale. For the anamnesis process, a standardized questionnaire was used. The patellar apprehension test was used to determine the tendency for dislocation. Finally, the results were compared with those of 10 centers across Europe.

Results and conclusion: The cohort (n = 45; M:W = 4:1) presented itself 5.34 ± 3.27 (1.24; 11.97) years [Mean ± SD; (Min.; Max.)] after the primary operation. Forty-one individuals (91.11%) did not experience any recurrent dislocations. Eighty-two point twenty-three percent of respondents reported no (16 individuals) or rare symptoms (21 individuals) in the index knee. The Patellar Apprehension Test yielded a negative result in 94.44% of cases. The median Kujala Score was 85.00 (28) points (median and interquartile range), and the BP II 2.0 averaged 64.68 ± 24.51 points [mean ± SD]. The SF-12 scores were determined to be 52.04 (13.10) [median (interquartile range)] (PCS-12) and 50.66 (17.99) [median (interquartile range)] (MCS-12). The MARX averaged 2.00 ± 6.00 [mean ± SD] points.

The aim of operative (re-) stabilization of the patellofemoral joint (PFJ), particularly in the young female subgroup (ages 13 to 17), representing the main share (35.55%) of the study cohort, with a success rate of >90%, can be considered a successful secondary preventive measure. In comparison with 10 other centers, our cohort ranks in the middle in terms of PROM (Patient-Reported Outcome Measures). With a median follow-up period of 5.3 years (Min. = 1.24 years; Max. = 11.97 years), we present the second-longest and second-largest patient follow-up since 2005.