Jeremy K. Rush, MD

A combination of bony and dynamic and static soft tissue stabilizers provides for stability of the patellofemoral joint. Therefore, the etiology of patellar instability is multifactorial and often includes trochlear dysplasia, patella alta, coronal malalignment, torsional abnormalities and incompetent medial soft tissue constraints. Recent studies have indicated that trochlear dysplasia is the key anatomic risk factor leading to persistent patellar instability. Though trochlear dysplasia is frequently present in patients with patellar instability, correction of this dysplasia through deepening trochleoplasty is only indicated in a subset of patients. This article describes the sulcus-deepening trochleoplasty, including indications and technical pearls.