Outcomes of Trochleoplasty vs Tibial Tubercle Osteotomy for Treatment of Patellar Instability Associated with Trochlear Dysplasia; A Systematic Review and Meta-analysis.

Purpose: To compare the outcomes of tibial tubercle osteotomy (TTO) and trochleoplasty for the treatment of patellar instability associated with trochlear dysplasia Methods: This was a systematic review of the literature including published articles that describe either trochleoplasty or TTO in addition to medial patellofemoral ligament reconstruction for the surgical treatment of patellar instability associated with trochleoplasty. Main outcomes assessed were Kujala and international knee documentation committee (IKDC) scores, in addition to recurrent instability and complications. Outcome measures reported were provided in a table format and a subjective analysis was performed.

Results: Ten studies were included with a total of 362 knees including 132 in the trochleoplasty group and 230 in the TTO group. Mean follow up ranged from 27.6 to 61.3 months. At the final follow up, both Kujala and IKDC scores improved significantly in all studies that reported both preoperative and postoperative scores in both groups. There was a total of 3 instability events in the trochleoplasty group as opposed to 21 in the TTO group.

Conclusion: Both procedures, trochleoplasty and TTO may provide satisfactory functional improvement in patients with patellar instability associated with trochlear dysplasia. However, trochleoplasty may be a better option to minimize the risk of recurrent instability.