TY - JOUR
T1 - Open and arthroscopic deepening trochleoplasty improves post-operative outcomes
T2 - A systematic review of the literature reveals lack of comparability between techniques
AU - Høj, Signe
AU - Lundegaard, Johanne Kofoed
AU - Blønd, Lars
AU - Lavard, Peter
AU - Rechter, Anke Simone
AU - Dippmann, Christian
AU - Barfod, Kristoffer W
N1 - © 2025 The Author(s). Knee Surgery, Sports Traumatology, Arthroscopy published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.
PY - 2026/1
Y1 - 2026/1
N2 - PURPOSE: Deepening trochleoplasty improves outcomes in patients with trochlear dysplasia. The aim of this systematic review was to present the outcomes after open thin-flap, open thick-flap and arthroscopic deepening trochleoplasty.METHODS: A systematic review was conducted using the PRISMA guidelines. Literature was searched in the PubMed, EMBASE and Cochrane databases on 16 December 2024. All studies from the inception of the databases to the date of the search were included in the search. Studies were included if they examined patients with patellar instability and trochlear dysplasia treated with either open or arthroscopic deepening trochleoplasty and reported pre- and post-operative outcomes. Two independent reviewers screened titles and abstracts, reviewed the full text and performed the quality assessment.RESULTS: A total of 32 studies, consisting of 1435 trochleoplasty cases in 1310 patients, were included. Of the included studies, 21 concerned open thin-flap trochleoplasty, 8 concerned open thick-flap trochleoplasty and 3 concerned arthroscopic trochleoplasty. The most used patient-reported outcome measures were the Kujala score, International Knee Documentation Committee score, visual analogue scale pain score, Lysholm Knee Score and Tegner Activity Scale; and the most reported radiological outcome measures were trochlear sulcus angle, trochlear bump, trochlear depth, tibial tubercle-trochlear groove distance, Caton-Deschamps index and patellar tilt. All three trochleoplasty techniques lead to improvements in post-operative outcome measures.CONCLUSION: Deepening trochleoplasty improves post-operative outcome using both open thin-flap, open thick-flap and arthroscopic deepening technique. Comparison between the techniques is challenging due to low methodological quality of studies. Further research is needed to document treatment effect and improve patient outcome.LEVEL OF EVIDENCE: Level IV.
AB - PURPOSE: Deepening trochleoplasty improves outcomes in patients with trochlear dysplasia. The aim of this systematic review was to present the outcomes after open thin-flap, open thick-flap and arthroscopic deepening trochleoplasty.METHODS: A systematic review was conducted using the PRISMA guidelines. Literature was searched in the PubMed, EMBASE and Cochrane databases on 16 December 2024. All studies from the inception of the databases to the date of the search were included in the search. Studies were included if they examined patients with patellar instability and trochlear dysplasia treated with either open or arthroscopic deepening trochleoplasty and reported pre- and post-operative outcomes. Two independent reviewers screened titles and abstracts, reviewed the full text and performed the quality assessment.RESULTS: A total of 32 studies, consisting of 1435 trochleoplasty cases in 1310 patients, were included. Of the included studies, 21 concerned open thin-flap trochleoplasty, 8 concerned open thick-flap trochleoplasty and 3 concerned arthroscopic trochleoplasty. The most used patient-reported outcome measures were the Kujala score, International Knee Documentation Committee score, visual analogue scale pain score, Lysholm Knee Score and Tegner Activity Scale; and the most reported radiological outcome measures were trochlear sulcus angle, trochlear bump, trochlear depth, tibial tubercle-trochlear groove distance, Caton-Deschamps index and patellar tilt. All three trochleoplasty techniques lead to improvements in post-operative outcome measures.CONCLUSION: Deepening trochleoplasty improves post-operative outcome using both open thin-flap, open thick-flap and arthroscopic deepening technique. Comparison between the techniques is challenging due to low methodological quality of studies. Further research is needed to document treatment effect and improve patient outcome.LEVEL OF EVIDENCE: Level IV.
KW - Arthroscopy
KW - Patellar dislocation
KW - Patellar instability
KW - Systematic review
KW - Trochlear dysplasia
KW - Trochleoplasty
KW - Surgical Flaps
KW - Joint Instability/surgery
KW - Femur/surgery
KW - Humans
KW - Patellar Dislocation/surgery
KW - Treatment Outcome
KW - Arthroscopy/methods
KW - Patient Reported Outcome Measures
U2 - 10.1002/ksa.12647
DO - 10.1002/ksa.12647
M3 - Review
C2 - 40095317
SN - 0942-2056
VL - 34
SP - 34
EP - 51
JO - Knee Surgery, Sports Traumatology, Arthroscopy
JF - Knee Surgery, Sports Traumatology, Arthroscopy
IS - 1
ER -