Good short-term results following arthroscopic deepening trochleoplasty combined with medial patellofemoral ligament reconstruction: surgical technique and outcomes

Purpose To report short-term results and clinical outcomes of arthroscopic deepening trochleoplasty combined with medial patellofemoral ligament (MPFL) reconstruction utilising standard arthroscopic instruments in patients of recurrent patellar dislocation with trochlear dysplasia. Methods This is a case series of 13 patients between the ages of 14 to 20 years who presented with recurrent patellar dislocation and severe trochlear dysplasia (Dejour grade D). They were treated surgically using an arthroscopic technique from February 2017 to January 2019, and were followed for 18-months. Patients were assessed pre-operatively and post-operatively (at 6, 12 and 18 months) with clinical scores (Tegner Activity Score, Lysholm Knee Score, Kujala Score). Results There were 69.2% females, and the mean age was 16.4 ± 2.0 years. There were statistically significant improvements in the mean Lysholm and Kujala scores when comparing pre-operative and post-operative scores at every follow up landmark (p<0.05). Comparing the pre-operative and 18 month’s post-operative scores – the Lysholm score improved from 68.2 ± 10.3 to 98.7 ± 2.1 (p<0.001); the Kujala score improved from 50.3 ± 12.0 to 95.4 ± 4.8 (p<0.001). Five patients were able to achieve premorbid Tegner activity level at 12 months, with an additional 5 patients achieving the same premorbid Tegner activity at the 18-month mark. The remaining 3 patients were able to attain >90% of their activity level at 18 month’s follow-up. No complications were observed during the follow-up period. Conclusions This proposed arthroscopic deepening trochleoplasty technique combined with MPFL reconstruction has demonstrated excellent and reproducible early clinical outcomes. Level of Evidence IV.