Trochleoplasty

Trochlea is the lower part of the thigh bone which articulates with the knee cap bone - patella. The shape of the trochlea can be abnormal in some which can be the major factor leading to dislocations of the patella. If the groove in the trochlear area is not well formed, the patella would not track properly. This can lead to recurrent dislocations of the patella. 

X-ray: X-ray is performed and is useful to understand the position of the patella and the alignment. 

MRI Scan: MRI Scan is the gold standard investigation to identify all the factors involved in the risk of patellar dislocation. The type and extent of the MPFL injury, trochlear shape, position of the patella, size of the patellar facets, condition of the cartilage of the patella and all the parameters that needs assessing before a decision regarding the surgery is made. 

Trochleoplasty Surgery

Trochleoplasty surgery is often performed in along with MPFL ligament reconstruction, chondroplasty (cartilage repair), high tibial osteotomy and / or Tibial tubercle distalisation and medialisation (leg bone surgery). In some patients, with multiple alignment issues. Of these, the trochleoplasty is probably the more complex and advanced level surgery. 

​Trochleoplasty involves taking a fine cut in the bone just under the trochlear area starting from the side, with a thin sliver of bone and cartilage lifted off. The central portion of the bone is deepened and then the lifted portion of the bone and cartilage is compressed back to the main bone by using vicryl tapes fixed down by using bio-anchors. 

Trochleoplasty Rehabilitation

Post-surgery, you are allowed to start mobilising with walker, however putting weight on the surgical side need to be avoided for 6 weeks. Full range of movement exercises are started early if the TT distalisation surgery has not been performed. You can expect to walk outdoor by 2 months. We expect you to be ready to start jogging by 4 months. Return to full activities including playing by 6 to 8 months.