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Trochlear dysplasia is the most commonly encountered pathoanatomy in patients who present with patellar instability. Outcomes of trochleoplasty procedures have shown low rates of recurrent instability and high patient-reported outcome scores. This article describes a "thin-flap" groove-deepening trochleoplasty combined with medial patellofemoral ligament reconstruction with a gracilis allograft and lateral retinacular lengthening to treat recurrent patellar instability due to high-grade trochlear dysplasia. This technique can obviate tibial tubercle osteotomy by normalizing the position of the trochlear groove and, subsequently, decreasing the tibial tubercle-to-trochlear groove distance.

arthroscopy techniques

Trochleoplasty, Medial Patellofemoral Ligament Reconstruction, and Open Lateral Lengthening for Patellar Instability in the Setting of High-Grade Trochlear Dysplasia