What did the study look at?
When the groove at the end of the thighbone in which the kneecap (patella) glides (the trochlea) is shallow or misshapen, the condition is called trochlear dysplasia, and it can cause the kneecap to dislocate repeatedly (patellar instability). In severe cases, trochleoplasty, an operation that deepens this groove, is increasingly used. In this operation the bone and cartilage layer (osteochondral flap) can be raised as a "thick" or a "thin" flap. The authors note that there is little literature on the outcomes of the two approaches. The aim was to compare clinical and radiographic outcomes between them.
How was it done?
A systematic review and meta-analysis was carried out following the PRISMA guidelines, with study quality assessed by two blinded reviewers. Studies were grouped by thick or thin flap technique. Data recorded included patient characteristics, indications, follow-up time, additional procedures, patient-reported outcome measures, radiographic measurements (tibial tubercle–trochlear groove [TT-TG] distance, Caton-Deschamps Index and sulcus angle), complications and redislocation rates. The level of evidence is reported as IV.
What did it find?
- Twenty-four studies including 927 patients met the inclusion criteria: 5 described a thick flap technique and 19 a thin flap technique.
- There was no significant difference in mean improvement in the Kujala score, which measures knee function, between the two techniques (p > 0.05).
- Both groups showed mean improvements in radiographic measurements based on TT-TG distance, Caton-Deschamps Index and sulcus angle.
- The overall rate of the kneecap dislocating again was 0.35%.
The authors' conclusion
The authors conclude that no significant difference in Kujala scores was seen between patients treated with thick and thin flap trochleoplasty. Radiographic measurements improved in both technique groups, and the overall redislocation rate was 0.35%.
Note: this article is based on the published abstract of the paper.
Reference
Eikani C, Knapik DM, Vadhera AS, Singh H, Polce E, Gürsoy S, Yanke AB, Chahla J. (2024). No significant difference in thick versus thin osteochondral flap trochleoplasty in the treatment of trochlear dysplasia: A systematic review. Knee Surgery, Sports Traumatology, Arthroscopy, 32(5):1168-1178.
DOI: 10.1002/ksa.12108
Free full text: Wiley Online Library (PDF)
This article summarises a published scientific paper for general information; it does not replace an examination or a personal medical assessment. Please consult your doctor about your symptoms.
