A 10 year follow-up study after Roux-Elmslie-Trillat treatment for cases of patellar instability

Pre-operative and follow-up radiographic evaluation included the weight-bearing anteroposterior and merchant views. Evaluation was carried out using the Insall-Salvati index, sulcus and congruence angle. The Roux-Elmslie-Trillat reconstruction operation was performed on 18 patients. The clinical evaluation at follow-up was performed using the Knee-Society-Score (KSS) and Tegner-Score.Subjective results of the operation were classed as excellent or good in 16 of the 18 patients ten years after surgery; persistent instability of the patella was recorded in only one of the 18 patients. The majority of patients returned to the same level of sporting activity after surgery as they had participated in before injury.The Roux-Elmslie-Trillat procedure could be recommended in cases presenting with an increased q-angle, trochlea dysplasia or failed soft tissue surgery. In the present study the majority of patients report a return to previous sporting activity ten years after surgery.Patellofemoral instability is generally defined as acute or chronic. Acute instability refers to a primary, traumatic episode in which the patella dislocates laterally, while chronic instability denotes recurrent dislocations. Medial dislocations are rare and are typically iatrogenic.According to the Dejour classification, patients presenting with patellofemoral instability can demonstrate several abnormalities in the patellofemoral joint including hypoplastic patella, genu recurvatum, trochlear dysplasia, dysplastic lateral femur condyle, patella alta, ligament laxity and excessive quadricep angles [1].Several interventions to correct the underlying pathology have been described in the literature [2,3]. However, in most cases, a single procedure does not result in a satisfactory outcome owing to the complexity of the disorder. Clinical results vary in terms of patient satisfaction from 20 to 70% [4], depending on the operating procedure used.Therefore, the long-term results (10 year follow-up) of