title: Trochleoplasty with a flexible osteochondral flap: results from an 11-year series of 214 cases.
abstract: OBJECTIVE
  The Bereiter trochleoplasty has been used in our unit for 12 years to manage recurrent patellar instability in patients with severe trochlea dysplasia. The aim of this study was to document the outcome of a large consecutive cohort of patients who have undergone this operation.
  
  
  METHODS
  Between June 2002 and August 2013, 214 consecutive trochleoplasties were carried out in 185 patients. There were 133 women and 52 men with a mean age of 21.3 years (14 to 38). All patients were offered yearly clinical and radiological follow-up. They completed the following patient reported outcome scores (PROMs): International Knee Documentation Committee subjective scale, the Kujala score, the Western Ontario and McMaster Universities Arthritis Index score and the short-form (SF)-12.
  
  
  RESULTS
  Outcomes were available for 199 trochleoplasties in 173 patients giving a 93% follow-up rate at a mean of 4.43 years (1 to 12). There were no infections or deep vein thromboses. In total, 16 patients reported further patella dislocation, giving an 8.3% rate of recurrence. There were 27 re-operations, giving a rate of re-operation of 14%. Overall, 88% were satisfied with the operation and 90% felt that their symptoms had been improved.
  
  
  CONCLUSIONS
  All PROMs improved significantly post-operatively except for the mental component score of the SF-12. Trochleoplasty performed using a flexible osteochondral flap is an effective treatment for recurrent patellar instability in patients with severe trochlea dysplasia and gives good results in the medium term. Cite this article:Bone Joint J2017;99-B:344-50.
authors.affiliation: Warwick Medical School, University of Warwick, University Hospitals of Coventry and Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Metcalfe
authors.affiliation: Avon Orthopaedic Centre, Bristol, UK.
authors.forename: D A
authors.initials: DA
authors.lastname: Clark
authors.affiliation: North Sydney Orthopaedic and Sports Medicine Centre, Sydney, Australia.
authors.forename: M A
authors.initials: MA
authors.lastname: Kemp
authors.affiliation: Avon Orthopaedic Centre, Bristol, UK.
authors.forename: J D
authors.initials: JD
authors.lastname: Eldridge
mesh_terms: D000293:Adolescent; D000328:Adult; D001178:Arthroplasty / Q000009:adverse effects / Q000379:methods; D001848:Bone Diseases, Developmental / Q000150:complications / Q000601:surgery*; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D002358:Cartilage, Articular / Q000601:surgery; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D031222:Patellar Dislocation / Q000209:etiology / Q000601:surgery*; D017060:Patient Satisfaction; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013524:Surgical Flaps; D055815:Young Adult
keywords: Patella dislocation; Trochlea dysplasia; Trochleoplasty