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Trochleoplasty for severe trochlear dysplasia significantly improves the quality of life of patients with symptomatic patellar instability

      Highlights

      • A single surgeon, retrospective case series of 51 trochleoplasties.
      • The clinical and radiological outcomes have been reported.
      • No literature on quality of life improvement following this procedure.
      • Trochleoplasty improves quality of life and clinical outcomes in our study.
      • BMI can be used to predict post-operative outcomes.

      Abstract

      Background

      Trochleoplasty is a recognized surgical technique to address severe trochlear dysplasia. The clinical and radiological outcomes of trochleoplasty surgery in trochlear dysplasia have been well reported. There is a paucity in literature regarding the correlation between trochleoplasty and quality of life (QoL). The aim of this study is to measure the improvement in QoL, in patients with severe trochlear dysplasia and recurrent patellar instability following trochleoplasty.

      Methods

      Between 2013 and 2019, 51 trochleoplasty cases were performed in 48 patients. They were identified from our prospectively kept database. All operations were performed by a fellowship trained consultant sports knee surgeon. Functional outcomes and QoL scores were assessed using Kujala, IKDC and EQ-5D index. Objective outcomes were obtained following each patient’s latest follow-up assessment.

      Results

      The mean age at operation was 22y (SD ± 4.7, range 14–37y) and the mean follow-up period was 21.6 months (SD ± 15.2, range 12–60 months). The mean Kujala score improved from 58.1 (SD 14.9) to 77.9 (SD 17.3) at latest follow-up (p < 0.001). The mean IKDC score improved from 40.5 (SD 14.2) to 69.5 (SD 22.8) at latest follow up (p < 0.001). The mean EQ-5D index also improved from 0.593 (SD 0.257) to 0.824 (SD 0.189) at latest follow-up (p = 0.003). A higher Body Mass Index (BMI; >30 kg/m2) was associated with inferior outcomes.

      Conclusion

      Trochleoplasty is an effective surgical technique which improves the QoL in patients suffering from patellar instability secondary to severe trochlear dysplasia. BMI can be used to predict post-operative outcomes.

      Keywords

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