Treatment of the Objective Patellofemoral Instability

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Abstract

Objectives: The aim of this study is to show the different surgical procedures for treating the objective patellar instability, including the different tibial tubercle osteotomies and the sulcus deepening trochleoplasty. Methods: This study analyzed the Caton-Deschamps index used for assessment of patellar height, the distance from the tibial tubercle to the troclear groove (TT-TG) on CT Scan in the axial view, and the different trochlear and patellar morphotypes. This study included 19 knees (19 patients) treated in an objective and documented patellofemoral instability. Results: We have had good results with both the transfer of the tibial tuberosity as the trochleoplasty. A reconstruction of the medial patellofemoral ligament was performed in both procedures. Recurrence of instability is very rare after these procedures and this is more likely to result from missed associated abnormalities. Conslusion: Accurate preoperative planning of the patellar height and determining the location of the tibial tubercle and the trochlear and patellar morphotypes for satisfactory results are required. However, as with any surgical procedure, both tibial tubercle osteotomy and the sulcus deepening trochleoplasty are susceptible of complications.