Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 26;8(1):109.
doi: 10.1186/s40634-021-00430-2.

Updated treatment guidelines for patellar instability: "un menu à la carte"

David H Dejour  1 , Guillaume Mesnard  1 , Edoardo Giovannetti de Sanctis  2   3
Affiliations

Updated treatment guidelines for patellar instability: "un menu à la carte"

David H Dejour et al. J Exp Orthop. .
No abstract available

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Two Imagings are mandatory to screen the trochlear dysplasia. X-Ray shows the 3 pillars of trochlear dysplasia. Slice imaging gives the shape of the trochlea but not the supratrochlear spur
Fig. 2
Fig. 2
Definition of the supratrochlear spur
Fig. 3
Fig. 3
Classification of the 4 types of trochlear dysplasia according to Dejour et al. [12] matching X-rays and Slice imaging
Fig. 4
Fig. 4
Patella Alta quantification: X-ray with the Caton-Deschamps index, MRI with the Sagittal Patellar Engagement index, notice the patellar tendon length
Fig. 5
Fig. 5
The updated treatment algorithm for patellar instability. Each abnormality has to be evaluated and surgically corrected when indicated (“menu à la carte”)
Fig. 6
Fig. 6
First time patellar dislocation with Lipohemarthrosis, MPFL rupture and Bone bruise. Remember to search for osteochondral fractures!
Fig. 7
Fig. 7
Three goals of the deepening trochleoplasty: 1) Deepen the trochlea. 2) Reduce the supratrochlear spur and make the trochlea flushes with the femoral anterior cortex. 3) Proximal realignment with the new groove aligned with the anatomical femoral axis
See this image and copyright information in PMC

References

    1. Askenberger M, Bengtsson Mostrom E, Ekstrom W, Arendt EA, Hellsten A, Mikkelsen C, Janarv PM. Operative repair of medial patellofemoral ligament injury versus knee brace in children with an acute first-time traumatic patellar dislocation: a randomized controlled trial. Am J Sports Med. 2018;46(10):2328–2340. doi: 10.1177/0363546518770616. - DOI - PubMed
    1. Beaufils P, Thaunat M, Pujol N, Scheffler S, Rossi R, Carmont M. Trochleoplasty in major trochlear dysplasia: current concepts. Sports Med Arthrosc Rehabil Ther Technol. 2012;4:7. doi: 10.1186/1758-2555-4-7. - DOI - PMC - PubMed
    1. Biedert RM. Lengthening osteotomy with or without elevation of the lateral trochlear facet. In: Dejour D, Zaffagnini S, Arendt EA, Sillanpää P, Dirisamer F, editors. Patellofemoral pain, instability, and arthritis. Berlin, Heidelberg: Springer; 2020.
    1. Biedert RM, Albrecht S. The patellotrochlear index: a new index for assessing patellar height. Knee Surg Sports Traumatol Arthrosc. 2006;14(8):707–712. doi: 10.1007/s00167-005-0015-4. - DOI - PubMed
    1. Blackburne JS, Peel TE. A new method of measuring patellar height. J Bone Joint Surg Br. 1977;59(2):241–242. doi: 10.1302/0301-620X.59B2.873986. - DOI - PubMed

LinkOut - more resources