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Erschienen in:
15.10.2020 | Original Article
A modification of the Bereiter trochleoplasty: indications, technique and outcomes
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 3/2021
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Introduction
The Bereiter technique is one recognised method of trochleoplasty that was described using a lateral para-patellar approach. We present our surgical technique and outcomes of this procedure using a medial para-patellar approach allowing for accurate soft tissue balancing of the patella.
Methods
In total, 27 consecutive patients underwent a Bereiter trochleoplasty using a medial approach. Patients completed pre- and post-operative Kujala scores. All patients’ medical records and imaging were reviewed to identify pre-operative indications, complications and re-dislocations.
Results
Data were collected on 31 trochleoplasty procedures in the 27 patients. Mean age at time of surgery was 25 (17–39), and 16 patients were females. Follow-up ranged from 13 to 60 months. All patients had severe trochlea dysplasia with recurrent instability. Three patients underwent a planned tibial tubercle transfer for a pre-operative raised TT-TG distance.
The mean pre-operative Kujala score was 53.9 (26–79) rising to 91.2 (88.6–100) post-operatively. A low post-operative Kujala score seen in patients had a significantly lower than average pre-operative score.
No patients had any further dislocations following surgery. Two patients complained of significant stiffness in the early post-operative period.
No patients required additional procedures to adequately balance the patella following the trochleoplasty combined with medial reefing plus lateral release involved in this modified technique.
Conclusion
A modified Bereiter trochleoplasty using a medial rather than a lateral para-patella approach gives excellent results.
Level of evidence
Level II evidence