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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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Autores principales: Wu, Chih-Hsuan, Hsu, Kuo-Yao, Cheng, You-Hung, Yang, Cheng-Pang, Sheu, Huan, Chang, Shih-Sheng, Chen, Chao-Yu, Chiu, Chih-Hao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10221988/
https://www.ncbi.nlm.nih.gov/pubmed/37241218
http://dx.doi.org/10.3390/medicina59050986
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author Wu, Chih-Hsuan
Hsu, Kuo-Yao
Cheng, You-Hung
Yang, Cheng-Pang
Sheu, Huan
Chang, Shih-Sheng
Chen, Chao-Yu
Chiu, Chih-Hao
author_facet Wu, Chih-Hsuan
Hsu, Kuo-Yao
Cheng, You-Hung
Yang, Cheng-Pang
Sheu, Huan
Chang, Shih-Sheng
Chen, Chao-Yu
Chiu, Chih-Hao
author_sort Wu, Chih-Hsuan
collection PubMed
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.
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spelling pubmed-102219882023-05-28 Reconstruction of High-Grade Trochlea Dysplasia in a Young Female with Recurrent Patella Dislocation: A Case Report Wu, Chih-Hsuan Hsu, Kuo-Yao Cheng, You-Hung Yang, Cheng-Pang Sheu, Huan Chang, Shih-Sheng Chen, Chao-Yu Chiu, Chih-Hao Medicina (Kaunas) 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–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. MDPI 2023-05-19 /pmc/articles/PMC10221988/ /pubmed/37241218 http://dx.doi.org/10.3390/medicina59050986 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Wu, Chih-Hsuan
Hsu, Kuo-Yao
Cheng, You-Hung
Yang, Cheng-Pang
Sheu, Huan
Chang, Shih-Sheng
Chen, Chao-Yu
Chiu, Chih-Hao
Reconstruction of High-Grade Trochlea Dysplasia in a Young Female with Recurrent Patella Dislocation: A Case Report
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 Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10221988/
https://www.ncbi.nlm.nih.gov/pubmed/37241218
http://dx.doi.org/10.3390/medicina59050986
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