{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T12:22:30Z","timestamp":1792498950254,"version":"4.5.0"},"reference-count":55,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T00:00:00Z","timestamp":1735084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Sulcus\u2010deepening trochleoplasty (TP) effectively treats patellofemoral (PF) instability (PFI) caused by high\u2010grade trochlear dysplasia (TD), but current evidence is based on small case series. We hypothesised, that TP would result in significant functional improvements and a low re\u2010dislocation rate but would not accelerate the progression of PF cartilage deterioration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed all TP cases performed by a single surgeon between 2015 and 2021. Inclusion criteria were postoperative Magnetic resonance imaging (MRI) &gt;6 and &gt;12 months and a clinical follow\u2010up &gt;12 months. Patients with simultaneous cartilage repair, open physes or incomplete records were excluded. Clinical outcomes were assessed using pre\u2010 and postoperative scores, postoperative Banff Patellofemoral Instability Instrument (BPII) 2.0 and Knee Injury and Osteoarthritis Outcome Score (KOOS), re\u2010dislocation rate and patient satisfaction. PF cartilage was evaluated via Area Measurement and Depth &amp; Underlying Structures (AMADEUS) scores preoperatively, at 6 months and at the final follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 113 patients (25.8\u2009\u00b1\u20098.3 years) with high\u2010grade TD (Dejour B\u2013D; mean lateral inclination angle: \u22122.9\u2009\u00b1\u20099.1\u00b0), 85% of whom had advanced cartilage lesions. All underwent TP, lateral retinacular lengthening (LRL) and medial patellofemoral ligament reconstruction (MPFL\u2010R). After 34.8\u2009\u00b1\u200920.9 months, function, pain levels and Tegner scores improved significantly (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). KOOS dimensions were: symptoms 79.9\u2009\u00b1\u200913.5, pain 86.4\u2009\u00b1\u200912.1, activity 91.9\u2009\u00b1\u20098.3, sports 71.7\u2009\u00b1\u200922.2 and quality\u2010of\u2010life 58.1\u2009\u00b1\u200923.8. BPII 2.0 was 64.3\u2009\u00b1\u200931.4. Preoperative AMADEUS scores (55.2\u2009\u00b1\u200917.4) remained stable at 6 months (<jats:italic>p<\/jats:italic>\u2009=\u20090.343) but improved to 58.4\u2009\u00b1\u200916.0 at 28.6 (12\u201389) months (<jats:italic>p<\/jats:italic>\u2009=\u20090.004). Complication and re\u2010dislocation rates were 5.3% and 1.8%, with 93% patient satisfaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Sulcus\u2010deepening TP with MPFL\u2010R and LRL yields good to excellent short\u2010term results without progressive chondral deterioration, enabling patients to return to their prior or higher activity levels despite advanced preoperative chondral lesions. TP can be considered a safe, joint\u2010preserving technique for PF stabilisation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level III, retrospective cohort study.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12566","type":"journal-article","created":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T10:04:02Z","timestamp":1735121042000},"page":"3156-3168","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Thin flap sulcus\u2010deepening trochleoplasty in patellar instability yields good functional outcomes without progressive cartilage deterioration in the short\u2010term follow\u2010up\u2014A retrospective single\u2010surgeon cohort study"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5083-8301","authenticated-orcid":false,"given":"Jannik","family":"Frings","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Janssen","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Krause","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl\u2010Heinz","family":"Frosch","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Department of Trauma Surgery, Orthopedics and Sports Traumatology BG Hospital Hamburg Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eik","family":"Vettorazzi","sequence":"additional","affiliation":[{"name":"Institute of Medical Biometry and Epidemiology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Weiler","sequence":"additional","affiliation":[{"name":"Sporthopaedicum Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arno","family":"Schmeling","sequence":"additional","affiliation":[{"name":"Sporthopaedicum Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,25]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-2274-1"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516663498"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.101B3.BJJ-2018-0795.R2"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2009.11.004"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2650-5"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-016-4365-x"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2603-z"},{"key":"e_1_2_12_9_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_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259671231171378"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.216.2.r00au07582"},{"key":"e_1_2_12_12_1","first-page":"317","article-title":"Patella infera. Apropos of 128 cases","volume":"68","author":"Caton J.","year":"1982","journal-title":"Revue de Chirurgie Orthopedique et Reparatrice de l'Appareil Moteur"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.101B5.BJJ-2018-1246.R1"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2016.03.010"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12319"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2020.06.009"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0b013e31803035ae"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465241253265"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-009-0933-8"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2023.10.001"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12108"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12270"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.3238\/arztebl.2020.0279"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-72332-9"},{"key":"e_1_2_12_25_1","first-page":"678","article-title":"Retro\u2010trochlear wedge reduction trochleoplasty for the treatment of painful patella syndrome with protruding trochleae. Technical note and early results","volume":"88","author":"Goutallier D.","year":"2002","journal-title":"Revue de Chirurgie Orthopedique et Reparatrice de l'Appareil Moteur"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515572143"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.09.017"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-5311-x"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/1947603519894728"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518759543"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1148\/101.1.101"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-013-1664-x"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/1947603516665444"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-022-00512-9"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.88B10.17834"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2021.103035"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4584-9"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515597679"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-06945-0"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211063914"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.99B3.37884"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-021-06705-6"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513478579"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-2321-y"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-07201-1"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2019.12.029"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-019-03244-1"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2015.01.017"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4766-5"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516680604"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4505-y"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-007-0300-4"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-006-0148-0"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512438762"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13103009"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05469-4"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.12566","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T12:07:52Z","timestamp":1760875672000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.12566"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,25]]},"references-count":55,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/ksa.12566"],"URL":"https:\/\/doi.org\/10.1002\/ksa.12566","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,25]]},"assertion":[{"value":"2024-10-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}