Poster 241: Outcomes of Trochleoplasty for Recurrent Patellar Dislocation in Adolescents with Open Physes

Objectives: Patellofemoral dislocation, the most severe presentation on spectrum of patellar instability, is common in adolescent populations. Trochlear dysplasia an integral component disorder, and procedures aimed at correcting instability by addressing this are often necessary. A theoretical risk injury to distal femoral physis exists these surgeries. At our institution, a thick-flap sulcus deepening technique used re-shape trochlear groove. The procedure not clearly delineated current literature. We investigated outcomes patients undergoing procedure, hypothesizing that with open physes less than 2 years remaining growth can safely successfully undergo trochleoplasty. Methods: Seventeen adolescents (21 knees) underwent trochleoplasty institution. Preoperative radiographs were evaluate leg axis patella alta. MRI was determine (sulcus depth, spur height, patellofemoral index) tibial tuberosity groove distance (TTTG) distance. postoperative AP lateral compare angle (LDFA) Blumensaat’s (BA). IKDC Kujala outcome scores measured clinical improvement. Results: Median age time operation 14.9 for girls 15.5 boys. Mean follow up 5.4 from surgery. two-year up, plates closed all but one knee. No differences length or alignment appreciated. There no statistically significant change (mean 0.74 degrees, p = 0.1074). 0.89 0.0477). score improved significantly 60.19 preoperatively 90.36 postoperatively, p= 0.0008. 59.37 87.21 0.00064. recurrent knee, requiring revision surgery femur Fulkerson osteotomies. Conclusions: Adolescent nearing skeletal maturity thick- flap resulting dysplasia. follow- there evidence disturbances, imaging demonstrated 1 degree difference LDFA BA maturity, which unlikely be significance. These findings should interpreted very carefully, as specific patient selection, expertise, extreme caution still necessary prevent iatrogenic physis.