Patient-reported Outcomes of Sulcus Deepening Trochleoplasty versus Tibial Tubercle Osteotomy in Patellofemoral Dysplasia: A Comparative Case Series

Abstract Background: Patellofemoral dysplasia characterized by patellofemoral instability often stems from a multifaceted etiology. No prior investigations have compared the patient-reported outcomes of sulcus deepening trochleoplasty (SDT) against those of tibial tubercle osteotomy (TTO). Objectives: The principal objective of this study is to compare the patient-reported outcomes observed in patients with patellofemoral dysplasia and concomitant patellofemoral instability, whom underwent SDT and TTO. Materials and Methods: Nineteen patients were divided into two groups: Group A ( n = 10) underwent TTO combined with extensive lateral release and Group B ( n = 9) underwent SDT. Pre- and post-operative assessments included Tegner and Kujala scores, apprehension, and Visual Analog Score. Image parameters included Dejour classification, tuberosity-trochlear groove distance, and Caton-Deschamps index (CDI). Results: The average age at the time of surgery was 23 ± 7 years. The average follow-up duration was 34 ± 17 months. No recurrent dislocations occurred, and no clinically significant deformities or complications were encountered. Overall postoperative CDI was 1.12 ± 0.15. No significant differences were found in the preoperative and postoperative measurements between both subgroups. The Kujala score and Tegner score improved from 65.1 ± 4.9 before surgery to 90.6 ± 3.6 after surgery for the Kujala score ( P < 0.001) and from 3.6 ± 1.4 before surgery to 5.9 ± 1.1 after surgery for the Tegner score ( P < 0.001). Conclusions: Patellofemoral dysplastic knees presenting with recurrent patella dislocation can be effectively treated through SDT or TTO. Of these options, TTO and SDT both demonstrated similar anatomical restoration and favorable patient-reported outcomes.