Thin Flap Trochleoplasty for High-Grade Trochlear Dysplasia
Bibliographic record
Abstract
Background: One of the most consistent pathoanatomic findings in lateral patellofemoral instability is trochlear dysplasia. Trochleoplasty is a procedure designed to deepen the trochlear groove, thus correcting trochlear pathoanatomy and improving patellofemoral tracking. Indications: Patients with high-grade trochlear dysplasia that includes anteriorization of the floor of the trochlear groove (trochlear bump >5 mm), with lateral patellofemoral instability. Technique Description: The technique described is a thin flap trochleoplasty. By an open lateral parapatellar approach, trochlear cartilage is elevated. A new groove is created by removing subchondral bone with a burr. The cartilage flap is then reduced on the subchondral bone, and gentle pressure is applied to the cartilage. Plastic deformity occurs, and the cartilage is fixed with bioabsorbable nails. This technique should be accompanied by a stabilizing procedure, such as a medial patellofemoral ligament reconstruction. Results: Thin-flap trochleoplasty has low redislocation rates (3%-4%) in appropriately selected patients. Multiple clinical studies and meta-analyses have shown good postoperative patient-reported outcome scores and improved postoperative knee scores. There is a high rate of patient satisfaction, return to work, and return to sports following surgery (>85%). Notable complications include patellofemoral osteoarthritis (7%-18%), knee ankylosis (4.4%), and the need for additional surgery (8%-11%). However, the risk of complications seems to be similar to other patellar-stabilizing procedure. Discussion/Conclusion: Trochleoplasty is a technically demanding surgical procedure but is safe, reliable, and effective in appropriately selected patients. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".