Anterior knee pain and trochlear dysplasia may be related. In some cases, trochleoplasty surgery can help.

Anterior knee pain is a symptom

First and foremost, anterior knee pain is a symptom, not a disease. Similarly, if you’ve been diagnosed with trochlear dysplasia—which means a flat groove in the patella—that doesn’t mean you’re sick. However, there are a few people who experience chronic anterior knee pain as a result of trochlear dysplasia. In this situation, some patients may benefit from a trochleoplasty procedure. You can read more about anterior knee pain—click here and about trochlear dysplasia—click here.

Scientific Evidence for Trochleoplasty in Chronic Anterior Knee Pain and Trochlear Dysplasia

In 2017, I published the first scientific article about trochleoplasty for patients with chronic anterior knee pain and trochlear dysplasia –you can find the article here. Now, in 2021, a confirmatory study has finally been published showing the same – you can find the article here.

An example

Here you see an MRI scan of a 36-year-old woman who had been suffering from debilitating pain for 20 years. She had been treated with arthroscopic housecleaning surgery and other surgeries that were completely ineffective in this context. On the MRI scan, you’ll see both severe trochlear dysplasia and osteoarthritis (arthrosis). She had to undergo surgery with the Hemicap Patellofemoral prosthesis. Had she been treated correctly at the age of sixteen, she would probably have avoided 20 years of severe anterior knee pain. Furthermore, it’s likely that she shouldn’t have had metal and plastic inserted at an early age.

Chronic anterior knee pain

Way back in 1998, I conducted a follow-up study of patients with anterior knee pain. Half of the patients were found to still have mild to moderate pain 5 years later. 10 percent had developed severe anterior knee pain. You can download a PDF copy here. 

Trochlear Dysplasia and Genu Varum

It has been shown that trochlear dysplasia and increased femoral anteversion may be related. Often, increased femoral anteversion is not easy to diagnose, which is why I now always recommend that patients be thoroughly examined for this condition. If increased femoral anteversion is present, it should be corrected if it is pronounced and there is chronic anterior knee pain. Read more on the page about inward-pointing kneecaps—kissing knees.

Reference

Is there a relationship between anterior knee pain and femoral trochlear dysplasia? Assessment of lateral trochlear inclination using magnetic resonance imaging. Click here