Distal realignment: Medialization of tibial tuberosity: The elmslie-trillat technique

Abstract

Patellofemoral problems are probably the most common knee complaints in adolescents and adults. The vague and general term chondromalacia patellae has been widely used in the past to describe retro-patellar pain and instability. The term patellofemoral malalignment (PFM) was introduced in 1979 by Insall [17] and since then, it indicates a wide range of pathological conditions from abnormal tracking of the patella on the trochlea with unbalanced transmitted loads on the cartilage, to acute and recurrent dislocation of the patella, which explains the anterior knee pain and patellar instability. This theory has influenced the development of several surgical procedures to correct the malalignment. At present only a small percentage of patients with patellofemoral pain are candidates for surgical correction of the malalignment [25]. According to Dejour et al. [11, 12], patellofemoral disorders can be classified into three major categories. Objective patellar instability is defined as true patellar dislocation or subluxation when trochlear dysplasia is present, potential patellar instability includes trochlear dysplasia when true patellar dislocation or subluxation has never occurred, and the third group covers patello-femoral pain syndrome. © 2010 Springer-Verlag Berlin Heidelberg.