Introduction
Trochleoplasty is another breakthrough and innovative procedure that has shown a greater impact in the field of orthopedic surgery. Any injuries to the knee can hamper the lifestyle of the individual. Trochleoplasty is a surgical procedure used in the management of patellar instability. Trochleoplasty procedure has served as a boon for patients suffering from chronic knee pain and instability, helping them to regain their active lifestyles. This article further highlights the purpose, procedure, and benefits of trochleoplasty procedure.
What Is Trochlear Dysplasia?
Trochlear dysplasia is a condition where the groove within the knee joint is shallow or misshapen. This can result in recurrent patellar dislocations causing severe pain and instability. The trochleoplasty procedure was introduced for the management of such situations.
Prevalence of Trochlear Dysplasia:
Trochlear dysplasia has been observed in 80 to 90 percent of patellar dislocation cases.
What Is Patellofemoral Instability?
The patella is also known as the “knee cap” and plays a crucial role in the complex mechanics of the knee joint. Patellofemoral instability refers to the condition where the knee cap does not glide smoothly within the groove of the thigh bone or femur. This malalignment of the knee cap can result in frequent dislocations, chronic pain, and a restricted range of motion. Physical therapy, knee cap splints, and braces are a few procedures that may provide temporary pain relief, but it does not last for a long time in severe cases. For severe cases, trochleoplasty offers a more lasting solution.
What Are Different Trochleoplasty Procedures?
Different types of trochleoplasty procedures are:
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Lateral Facet Elevation Trochleoplasty Procedure: This procedure is usually performed for the management of trochlear dysplasia. This method is mostly used in cases when there are prominent lateral facets of the trochlear groove causing patellar instability. As the name suggests, the purpose of this method is to elevate the lateral facet to improve the patellar stability within the knee joint.
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Sulcus Deepening Trochleoplasty Procedure: The sulcus deepening process involves deepening the trochlear groove by forming groves in the existing grooves. The purpose of this surgical technique is to achieve increased height and depth of the trochlear groove. This procedure helps to increase patellar stability.
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Recession Wedge Trochleoplasty Procedure: In the recession wedge Trochleoplasty procedure, the surgeon aims to reposition the trochlear groove by moving it towards the hip (more proximally). The aim of this technique is to realign the patella within the joint and prevent lateral dislocations.
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Dejour Trochleoplasty: This procedure involves deepening the trochlear groove to provide a natural anatomical shape to the grove.
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Bone Trochleoplasty: This technique involves reshaping the bony architecture of the trochlear groove. This procedure helps to achieve patellar stability within the knee joint.
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Cartilage Trochleoplasty: This method involves smoothening or reshaping the articular cartilage of the joint to achieve patellar stability.
Out of all these procedures, the sulcus deepening procedure and recession wedge procedure are the most commonly used trochleoplasty procedures. However, the selection of trochleoplasty procedures depends on various factors, like the patient's anatomy and the severity of trochlear dysplasia. The decision on the type of trochleoplasty procedure to be used should be made by the orthopedic surgeon after a thorough clinical and radiographic examination of the patient's condition.
How Is Trochleoplasty Procedure Performed?
Trochleoplasty is a surgical procedure that involves reshaping the groove in the femur that guides the movement of the patella. Orthopedic surgeons (specialists in bone surgeries) perform a cut or incision over the knee before initiating the surgical procedure. Orthopedic Surgeons use specific types of instruments like bur and handpiece to reconstruct, reshape, and deepen this groove to create a stable and functional path for the kneecap. Any abnormal bone and cartilage are removed, and the patella is repositioned.
What Are the Benefits and Outcomes of Trochleoplasty Procedure?
There are various benefits of the trochleoplasty procedure, such as:
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Increased Knee Stability: It restores stability and helps realign the knee joint by restoring proper patella alignment in the trochlear groove.
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Pain Reduction: Trochleoplasty procedure helps to reduce and eliminate the pain by reducing the friction between the joints.
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Reduced Risk of Dislocations: Trochleoplasty prevents the risk of further dislocation of joints.
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Long-Term Improvement: This surgical procedure improves the overall function of the knee, thereby increasing athletic performance.
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Enhanced Range of Motion: Improves the range of motion of the knee joints.
What Are the Associated Risks of Trochleoplasty Procedure?
The potential risks and complications associated with trochleoplasty procedure are:
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Risk of infection.
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Trochleoplasty surgical procedures can result in complications like the formation of blood clots.
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There are chances of damage to the nerve during a trochleoplasty surgical procedure.
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Trochleoplasty carries the chances of knee joint stiffness after the surgical procedure.
How Long Does It Take To Recover From the Trochleoplasty Procedure?
Trochleoplasty is a complex surgical procedure and needs lots of skills or expertise of orthopedic surgeons to perform the procedure. The recovery time from the trochleoplasty procedures depends on individual patients, the severity of knee injuries, the extent of the surgical procedure, and the patient's adherence to post-surgical protocols.
For the speedy recovery of the patients, rehabilitation therapy, physical therapy, and moderate exercises are advised by the doctor for early recovery.
What Is the Success Rate of Trochleoplasty?
However, there are a number of studies done regarding trochlear dysplasia treated with trochleoplasty, with and without reconstruction. Reported patient satisfaction rates have ranged from as low as 67 percent to as high as 95.7 percent. Trochleoplasty for the treatment of patellar instability has a high success rate.
Conclusion
Knee injuries or knee joint instability can result in a drastic impact on the daily lifestyle of the individual. Trochleoplasty procedure has presented groundbreaking advancement in the field of medicine, especially in the field of orthopedic procedures. Trochleoplasty procedure helps the patient reduce knee pain, improve range of motion, improve knee stability, and allow the patient to resume their daily activities. It is advised to consult with an orthopedician in case of severe knee injuries or knee stiffness.
