Abstract
This study compared the outcomes of tibial tubercle osteotomy (TTO) and trochleoplasty
for the treatment of patellar instability associated with trochlear dysplasia. This
was a systematic review of the literature including published articles that describe
either trochleoplasty or TTO in addition to medial patellofemoral ligament reconstruction
for the surgical treatment of patellar instability associated with trochleoplasty.
Main outcomes assessed were Kujala and International Knee Documentation Committee
(IKDC) scores, in addition to recurrent instability and complications. Outcome measures
reported were provided in a table format and a subjective analysis was performed.
Ten studies were included with a total of 362 knees including 132 in the trochleoplasty
group and 230 in the TTO group. Mean follow-up ranged from 27.6 to 61.3 months. At
the final follow-up, both Kujala and IKDC scores improved significantly in all studies
that reported both preoperative and postoperative scores in both groups. There was
a total of three instability events in the trochleoplasty group as opposed to 21 in
the TTO group. Both procedures, trochleoplasty and TTO, may provide satisfactory functional
improvement in patients with patellar instability associated with trochlear dysplasia.
However, trochleoplasty may be a better option to minimize the risk of recurrent instability.
Level of evidence: level IV, systematic review of level III and level IV studies.
Keywords trochleoplasty - tibial tubercle osteotomy - trochlear dysplasia - patellar instability
