Compared with combined trochleoplasty and medial patellofemoral ligament reconstruction in patients with trochlear dysplasia, trochleoplasty alone showed lower outcome scores and higher rates of residual instability, according to results.
Researchers searched current literature in PubMed, EMBASE and Medline databases using the terms ‘trochleoplasty’ and ‘medial patellofemoral ligament (MPFL) reconstruction' and identified 515 abstracts. Of these abstracts, six articles met inclusion criteria. The six articles included information for 192 knees in 168 patients with severe trochlear dysplasia. In the meta-analysis, the Kujala score was analyzed as the primary clinical outcome. Investigators calculated pooled estimates for postoperative complications.
Results showed three articles with a total of 111 knees that underwent isolated trochleoplasty and three articles with a total of 81 knees that underwent trochleoplasty combined with MPFL reconstruction. The preoperative Kujala score increased significantly at the final follow-up in patients who underwent isolated trochleoplasty by 21.39 points and by 24.91 points in patients who underwent trochleoplasty combined with MPFL reconstruction.
The rates of subjective patellar instability, which included subluxation and anterior knee pain, were 1.03% for patients who underwent isolated trochleoplasty and 8.45% for those who underwent trochleoplasty with MPFL reconstruction. Rates of objective patella re-dislocation in patients who underwent isolated trochleoplasty and trochleoplasty with MPFL reconstruction were 2.06% and 0%, respectively.
There were 8.24% of patients who underwent trochleoplasty and returned to the OR for additional surgery and 7.04% of patients who underwent trochleoplasty with MPFL reconstruction and returned to the OR. – by Monica Jaramillo
Disclosures: The authors report no relevant financial disclosures.