{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T20:58:09Z","timestamp":1787864289920,"version":"build-2784847793"},"reference-count":42,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:00:00Z","timestamp":1724284800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Trochlear dysplasia is a major risk factor for recurrent patellar instability, reduced quality of life\u00a0and osteoarthritis of the patellofemoral joint. Patellar instability in patients with trochlear dysplasia can be treated by trochleoplasty, usually in combination with medial patellofemoral ligament reconstruction (MPFL\u2010R). An \u00e0 la carte treatment algorithm, which also addresses patella alta, lateralisation of the tibial tuberosity\u00a0and valgus or torsional malalignment when present has been standard in one clinic for treatment of patellar instability patients since 2009, based on the hypothesis that it results in optimal subjective and clinical outcome, normalisation of the lateral trochlea inclination (LTI) angle and a low rate of patellar redislocation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective study reports the 5\u2010year results for consecutive patients with high\u2010grade trochlea dysplasia operated according to the algorithm 2010\u20132017, evaluated preoperatively and 1, 2\u00a0and 5 years postoperatively. Clinical information on previous surgery and postoperative patellar stability, range\u2010of\u2010motion (ROM)\u00a0and subsequent surgery were registered. Subjective outcome was evaluated by four patient\u2010reported outcome measures (PROMs): Kujala, Lysholm, International Knee Documentation Committee and Knee injury and Osteoarthritis Outcome Score. The LTI angle was measured pre\u2010 and postoperatively on magnetic resonance imaging scans.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 131 patients (87 females) with a median age of 22 years (range: 14\u201338). All had a trochleoplasty and an MPFL\u2010R. Additional procedures (tibial tuberosity medialisation\/distalisation and\/or femoral\/tibial osteotomy) were performed in 52%. All PROM scores improved from preoperatively to 1\u2010year follow\u2010up with further improvement at 2 and 5 years after surgery (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Three patients (2%) had a traumatic patellar dislocation 9, 12\u00a0and 24 months postoperatively\u00a0and 38% underwent subsequent surgery (hardware removal, arthroscopically assisted brisement force, knee arthroscopy). A normalisation of the LTI angle (\u226511\u00b0) was achieved in 76%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Treatment according to the \u00e0 la carte algorithm for patients with patellar instability and high\u2010grade trochlear dysplasia resulted in significant clinical and subjective improvement in all PROM scores and a very low redislocation rate (2%) 5\u00a0years after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level II.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12432","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T14:26:09Z","timestamp":1724336769000},"page":"401-412","source":"Crossref","is-referenced-by-count":15,"title":["Good 5\u2010year results and a low redislocation rate using an \u00e0 la carte treatment algorithm for patellofemoral instability in patients with severe trochlea dysplasia"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4990-6802","authenticated-orcid":false,"given":"Christian","family":"Dippmann","sequence":"first","affiliation":[{"name":"Section of Sportstraumatology M51, Department of Orthopedic Surgery Bispebjerg and Frederiksberg Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Lavard","sequence":"additional","affiliation":[{"name":"Section of Sportstraumatology M51, Department of Orthopedic Surgery Bispebjerg and Frederiksberg Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anette Holm","family":"Kourakis","sequence":"additional","affiliation":[{"name":"Section of Sportstraumatology M51, Department of Orthopedic Surgery Bispebjerg and Frederiksberg Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volkert","family":"Siersma","sequence":"additional","affiliation":[{"name":"Department of Public Health, The Research Unit for General Practice and Section of General Practice University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Copenhagen University Hospital, Bispebjerg University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Talibi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Copenhagen University Hospital, Bispebjerg University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Rindom","family":"Krogsgaard","sequence":"additional","affiliation":[{"name":"Section of Sportstraumatology M51, Department of Orthopedic Surgery Bispebjerg and Frederiksberg Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,22]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518803936"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2603-z"},{"key":"e_1_2_12_4_1","first-page":"281","article-title":"Die Trochleaplastik als chirurgische Therapie der rezidivierenden Patellaluxation bei Trochleadysplasie des Femurs","volume":"7","author":"Bereiter H.","year":"1994","journal-title":"Arthroskopie"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.216.2.r00au07582"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967119864868"},{"issue":"5","key":"e_1_2_12_7_1","first-page":"317","article-title":"Patella infera. 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