The Modified Trochleoplasty for Trochlear Dysplasia Types B and D

Abstract

Trochlear dysplasia is a major risk factor for recurrent patellar instability, often requiring surgical intervention in high-grade cases. The present modified trochleoplasty technique, known as the “Brazilian trochleoplasty,” is a reproducible technique developed by the Brazilian Storm Knee Research Group, which reshapes the trochlear groove while preserving cartilage integrity. Our technique is indicated for patients with recurrent patellar dislocation; abnormal patellar tracking, such as the J-sign; and high-grade trochlear dysplasia classified as Dejour types B and D, with trochlear prominence greater than 5 mm. This approach creates a single central sulcus without additional osteotomies, simplifying the procedure while ensuring anatomic precision. Fixation is achieved using headless compression screws, enhancing stability while minimizing cartilage damage. Compared with traditional sulcus-deepening techniques, the modified trochleoplasty offers a more accessible and effective alternative, improving patellar stability and reducing complications such as stiffness. Its stepwise methodology facilitates reproducibility, making it a viable option for young, active patients with severe trochlear dysplasia.