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)
Trochanteric Bursitis
10Hip-Treatment and Surgeries
Gluteal Repair
Labral Debridement
Labral Reconstruction
Labral Repair
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
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
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)
20Shoulder Care
10Shoulder-Conditions and Injuries
AC Joint Injuries
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


 The kneecap (patella) is a small bone in the front of the knee that helps support the extensor mechanism (quadriceps and patellar tendons). As the knee bends, the patella glides along a groove on the femur bone – the trochlea. Patellar instability refers to a condition in which the patella slides out of the trochlea (dislocates). Some individuals have a shallow trochlear groove (a flat trochlea). When the trochlear groove is shallow or flat, the patella is unstable as the knee bends and can slip out of place (dislocate). In those patients who do not improve with non-surgical management, Dr. Welch may recommend surgical intervention.

The goal of trochleoplasty is to create a deeper trochlea to stabilize the patella. During surgery, Dr. Welch makes an incision adjacent to the patella and identifies the trochlea. Using guide pins, Dr. Welch then makes cuts in the femur bone (around the trochlea) and repositions the cartilage and bone into a deep, V-shape. Dr. Welch is careful to deepen the groove enough to stabilize the patella. Usually, patients who require a trochleoplasty require an additional procedure, such as an MPFL reconstruction, to fully stabilize the patella.

Post-Operative Rehabilitation

Following surgery, full weight-bearing is encouraged with the knee locked in a brace in the extended position. Dr. Welch also recommends intermittent icing, straight leg raises for quad strength, and starting a dedicated physical therapy protocol one week after surgery. The physical therapist focuses on reducing swelling in the knee, range of motion, and restoring strength to the limb and core. Dr. Welch recommends advancing the physical therapy program to cutting, pivoting, and sport-specific activities approximately four months after surgery. Most patients return to competitive sports approximately six months after surgery. It is very important to follow the rehabilitation process carefully to achieve the best outcome.