Reconstruction of High-Grade Trochlea Dysplasia in a Young Female with Recurrent Patella Dislocation: A Case Report
The patellofemoral joint involves a combination of bony structures and soft tissues to maintain stability. Patella instability is a disabling condition, and the cause is multifactorial. The main risk factors include patella alta, trochlea dysplasia, excessive tibial tuberosity to trochlea grove (TT–...
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| Format: | Article |
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MDPI AG
2023-05-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/5/986 |
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| author | Chih-Hsuan Wu Kuo-Yao Hsu You-Hung Cheng Cheng-Pang Yang Huan Sheu Shih-Sheng Chang Chao-Yu Chen Chih-Hao Chiu |
| author_facet | Chih-Hsuan Wu Kuo-Yao Hsu You-Hung Cheng Cheng-Pang Yang Huan Sheu Shih-Sheng Chang Chao-Yu Chen Chih-Hao Chiu |
| author_sort | Chih-Hsuan Wu |
| collection | DOAJ |
| description | The patellofemoral joint involves a combination of bony structures and soft tissues to maintain stability. Patella instability is a disabling condition, and the cause is multifactorial. The main risk factors include patella alta, trochlea dysplasia, excessive tibial tuberosity to trochlea grove (TT–TG) distance, and excessive lateral patella tilt. In this case report, we highlight the thinking process of diagnosis and method for selecting the optimal treatment in accordance with the guidelines by Dejour et al. when we are presented with a patient with patella instability. A 20-year-old Asian woman without underlying medical conditions, presented with recurrent (>3 episodes) right patella dislocation for 7 years. Investigations revealed a type D trochlea dysplasia, increased TT–TG distance, and excessive lateral tilt angle. She underwent trochlea sulcus deepening, sulcus lateralization and lateral facet elevation, lateral retinacular release, and medial quadriceps tendon–femoral ligament (MQTFL) reconstruction. Due to the complexity behind the anatomy and biomechanics of patella instability, an easy-to-follow treatment algorithm is essential for the treating surgeon to provide effective and efficient treatment. MQTFL reconstruction is recommended for recurrent patella dislocation due to satisfactory clinical and patient reported outcomes and a reduced risk of iatrogenic patella fracture. Controversies for surgical indication in lateral retinacular release, and whether the sulcus angle is an accurate parameter for diagnosis of trochlea dysplasia, remain, and further research is required. |
| first_indexed | 2024-03-11T03:30:03Z |
| format | Article |
| id | doaj.art-1d3a74cdb28a43d5b15bc69457184772 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T03:30:03Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-1d3a74cdb28a43d5b15bc694571847722023-11-18T02:23:17ZengMDPI AGMedicina1010-660X1648-91442023-05-0159598610.3390/medicina59050986Reconstruction of High-Grade Trochlea Dysplasia in a Young Female with Recurrent Patella Dislocation: A Case ReportChih-Hsuan Wu0Kuo-Yao Hsu1You-Hung Cheng2Cheng-Pang Yang3Huan Sheu4Shih-Sheng Chang5Chao-Yu Chen6Chih-Hao Chiu7Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, TaiwanDepartment of Orthopedic Surgery, New Taipei Municipal Tucheng Hospital, New Taipei City 236, TaiwanDepartment of Orthopedic Surgery, New Taipei Municipal Tucheng Hospital, New Taipei City 236, TaiwanDepartment of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, TaiwanDepartment of Orthopedic Surgery, Taoyuan Chang Gung Memorial Hospital, Taoyuan 333, TaiwanDepartment of Orthopedic Surgery, Taoyuan Chang Gung Memorial Hospital, Taoyuan 333, TaiwanDepartment of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, TaiwanDepartment of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, TaiwanThe patellofemoral joint involves a combination of bony structures and soft tissues to maintain stability. Patella instability is a disabling condition, and the cause is multifactorial. The main risk factors include patella alta, trochlea dysplasia, excessive tibial tuberosity to trochlea grove (TT–TG) distance, and excessive lateral patella tilt. In this case report, we highlight the thinking process of diagnosis and method for selecting the optimal treatment in accordance with the guidelines by Dejour et al. when we are presented with a patient with patella instability. A 20-year-old Asian woman without underlying medical conditions, presented with recurrent (>3 episodes) right patella dislocation for 7 years. Investigations revealed a type D trochlea dysplasia, increased TT–TG distance, and excessive lateral tilt angle. She underwent trochlea sulcus deepening, sulcus lateralization and lateral facet elevation, lateral retinacular release, and medial quadriceps tendon–femoral ligament (MQTFL) reconstruction. Due to the complexity behind the anatomy and biomechanics of patella instability, an easy-to-follow treatment algorithm is essential for the treating surgeon to provide effective and efficient treatment. MQTFL reconstruction is recommended for recurrent patella dislocation due to satisfactory clinical and patient reported outcomes and a reduced risk of iatrogenic patella fracture. Controversies for surgical indication in lateral retinacular release, and whether the sulcus angle is an accurate parameter for diagnosis of trochlea dysplasia, remain, and further research is required.https://www.mdpi.com/1648-9144/59/5/986patella dislocationtrochlea dysplasiaDejour classification |
| spellingShingle | Chih-Hsuan Wu Kuo-Yao Hsu You-Hung Cheng Cheng-Pang Yang Huan Sheu Shih-Sheng Chang Chao-Yu Chen Chih-Hao Chiu Reconstruction of High-Grade Trochlea Dysplasia in a Young Female with Recurrent Patella Dislocation: A Case Report Medicina patella dislocation trochlea dysplasia Dejour classification |
| title | Reconstruction of High-Grade Trochlea Dysplasia in a Young Female with Recurrent Patella Dislocation: A Case Report |
| title_full | Reconstruction of High-Grade Trochlea Dysplasia in a Young Female with Recurrent Patella Dislocation: A Case Report |
| title_fullStr | Reconstruction of High-Grade Trochlea Dysplasia in a Young Female with Recurrent Patella Dislocation: A Case Report |
| title_full_unstemmed | Reconstruction of High-Grade Trochlea Dysplasia in a Young Female with Recurrent Patella Dislocation: A Case Report |
| title_short | Reconstruction of High-Grade Trochlea Dysplasia in a Young Female with Recurrent Patella Dislocation: A Case Report |
| title_sort | reconstruction of high grade trochlea dysplasia in a young female with recurrent patella dislocation a case report |
| topic | patella dislocation trochlea dysplasia Dejour classification |
| url | https://www.mdpi.com/1648-9144/59/5/986 |
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