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Trochlear Dysplasia - Tyler Welch, MD
York, ME (207) 363 3490 | Portsmouth, NH (603) 431 1121

20Hip Care
10Hip-Conditions and Injuries
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Deep Gluteal Space Syndrome
Labral Tears
Psoas Impingement (Internal Snapping Hip)
PVNS
Trochanteric Bursitis
10Hip-Treatment and Surgeries
Acetabuloplasty
Chondroplasty
Femoroplasty
Gluteal Repair
Labral Debridement
Labral Reconstruction
Labral Repair
Nanofracture
Psoas Release
Trochanteric Bursa Debridement
33Knee Care
13Knee Conditions and Injuries
ACL Tear
Cartilage Injury
Discoid Meniscus
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteoarthritis
Osteochondritis Dessicans
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
20Knee Treatment and Surgeries
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Medial Patellofemoral Ligament (MPFL) Reconstruction
Nanofracture
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Knee Replacement (MAKO)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Total Knee Replacement (MAKO)
Trochleoplasty
20Shoulder Care
10Shoulder-Conditions and Injuries
AC Joint Injuries
Arthritis
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
10Shoulder-Treatment and Surgeries
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement

TROCHLEAR DYPLASIA

The trochlea is a groove in the femur bone underneath the kneecap (patella). The walls of the trochlea stabilize the patella and allow it to glide down the center of the trochlea as the knee bends. It is important for the patella to glide down the middle of the trochlea because a centralized patella increases the strength and efficiency of the quadriceps of the thigh (knee extensor mechanism).

In some individuals, the trochlea does not develop normally. Instead of a groove, some patients have a flat or a dome-shaped trochlea. This condition is called trochlear dysplasia. When an individual has a flat or dome-shaped trochlea, the patella loses stability and can track to the outside of the knee as the knee bends. Individuals with trochlear dysplasia are much more likely to dislocate the patella compared to individuals with a normal trochlea.

Symptoms

  • Achy pain in the front of the knee with squatting and stairs
  • Sense of kneecap slipping or moving out of place

Diagnosis And Treatment

Dr. Welch considers each patient’s symptoms, as well as a detailed physical examination, x-rays, and sometimes an MRI of the knee to make the diagnosis of trochlear dysplasia. Dr. Welch recommends non-surgical management for most patients with trochlear dysplasia. A dedicated physical therapy program is a very important part of the treatment plan. Physical therapy focuses on strengthening of the core muscles, hip muscles, as well as the quadriceps to help stabilize the patella. Other non-surgical treatment options include a stabilizing brace and oral anti-inflammatory medication. In those patients who do not improve with non-surgical management, Dr. Welch may recommend surgical intervention.


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