Evaluation of the Roux-Elmslie-Trillat procedure for knee extensor realignment

Abstract

One method for correction of patellofemoral malalignment in acute and recurrent dislocations and subluxations of the patella involves a lateral retinacular release, medial capsular reefing, and medial displacement of the infrapatellar tendon insertion. The procedures was originally described by Roux and later modified and popularized by Elmslie and Trillat. It allows adequate evaluation and easy adjustment of the extensor mechanism at the time of surgery. This current report is an evaluation of 116 of these procedures followed for at least one year and examined by an orthopaedic surgeon. This evaluation indicates that this is a satisfactory method for prevention of recurrent subluxation of the patella with recurrence in only 7% of the cases. A critical evaluation of the results of the procedure reveals only 66% were rated as good or excellent. The results were directly related to associated intraarticular pathology such as hemarthrosis, patellar chondromalacia, degenerative changes on the femoral or tibial articular surfaces, torn or absent semilunar cartilages, torn anterior cruciate ligaments, and insufficient correction of either patella alta or a wide quadriceps angle. The procedure has been slightly modified and the indications for the procedure have been revised.