Trochleoplasty Surgery

What is the trochlea?

The trochlea is the groove at the end of the thigh bone (femur) where the kneecap (patella) sits and moves when you bend or straighten your leg.

In some people, this groove is too shallow or shaped abnormally. This can cause the kneecap to slip out of place (dislocate), leading to pain, swelling, and instability.

What is trochleoplasty surgery?

A trochleoplasty is an operation to reshape the trochlear groove, making it deeper so the kneecap fits more securely.

The aim of the surgery is to:

·       Improve the stability of the kneecap.

·       Reduce the risk of further dislocations.

·       Relieve pain and improve knee function.

Why might I need this operation?

Mr Tang may recommend a trochleoplasty if:

·       You have repeated kneecap dislocations.

·       You experience persistent pain or instability due to trochlear dysplasia (abnormal groove shape). A domed shaped groove is usually a strong indication for surgery.

·       Non-surgical treatments such as physiotherapy, bracing, or less invasive operations have not helped.

Trochleoplasty is often combined with other procedures, such as MPFL reconstruction or tibial tubercle transfer, depending on your individual knee anatomy.

What does the operation involve?

·       The operation is usually carried out under a general anaesthetic.

·       The surgeon carefully reshapes and deepens the trochlear groove.

·       The kneecap is then repositioned to move smoothly in the new groove.

·       Sometimes, additional soft tissue or bone procedures are carried out to improve alignment.

·       The operation usually takes around 1–2 hours.

Benefits of surgery

·       Reduces the risk of future kneecap dislocations.

·       Improves knee stability and confidence.

·       Can reduce pain and improve movement.

·       Helps protect the knee from further damage.

Risks and complications

As with any operation, there are risks. These include:

·       Infection.

·       Bleeding or blood clots (deep vein thrombosis).

·       Stiffness or reduced movement in the knee.

·       Persistent pain or swelling.

·       Fracture of the femur.

·       Failure of the surgery, with ongoing instability.

·       Possible need for further surgery in the future.

·       Risk of cartilage necrosis (failure of the cartilage to heal leading to early onset and persistent arthritis within the knee).

Recovery and rehabilitation

·       You may need to stay in hospital for 1–2 days.

·       A knee brace and crutches are often required for several weeks.

·       Physiotherapy is essential to regain movement and strength.

·       Driving is usually possible after 6–8 weeks, depending on progress.

·       Return to sports or high-impact activity may take 9–12 months.

Recovery times vary depending on your age, activity level, and whether other procedures were performed at the same time.

Looking after yourself after surgery

·       Keep your wound clean and dry for 2 weeks after surgery.

·       Take prescribed pain relief.

·       Use ice and elevation to reduce swelling.

·       Follow your physiotherapist’s exercises carefully.

·       Avoid twisting or heavy loading of the knee until Mr Tang or your physiotherapist says it is safe.

When to seek help

Contact my team if you notice:

·       Severe or increasing pain.

·       Redness, heat, or discharge from the wound.

·       Fever or feeling unwell.

·       Sudden calf pain, swelling, or shortness of breath (possible blood clot).

Frequently asked questions

Will my kneecap be stable after surgery? Most patients have improved stability and fewer dislocations, but there is no guarantee that dislocations will never happen again.

Will I get arthritis after this surgery? Reshaping the groove can protect your joint in the long term, but arthritis can still develop, especially if you’ve had many dislocations before surgery, or the cartilage does not heal to the bone as expected.

When can I return to sport? Light activity may be possible within a few months, but contact or pivoting sports usually take 9–12 months.