Trochlea Anatomy and Surgery

Trochlea anatomy and its effect on the stability of the patellofemoral joint is a complex topic. In the setting of patellar instability, multiple anatomic factors may contribute to instability. Comprehensive preoperative planning must be performed to appropriately address each potential pathologic factor in order to avoid future recurrence postoperatively. The selected surgical approach is dependent upon a patient’s alignment, severity of dysplasia, patellar height, and deficient soft tissue stabilizers. Trochleoplasty is a technically demanding procedure; however, with careful patient selection, it has been found to be a reliable surgical method to address patellar instability in the setting of severe trochlear dysplasia with a low rate of recurrent instability.