20Shoulder Care
AC Joint Injuries
Arthritis
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
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
28Knee Care
ACL Tear
Cartilage Injury
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteoarthritis
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
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
Nanofracture
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Trochleoplasty
17Hip Care
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Labral Tears
Psoas Impingement (Internal Snapping Hip)
Trochanteric Bursitis
Acetabuloplasty
Chondroplasty
Femoroplasty
Gluteal Repair
Labral Debridement
Labral Repair
Labral Reconstruction
Nanofracture
Trochanteric Bursa Debridement
2Biologics
Bone Marrow Aspirate Stem Cell Concentrate (BMC)
Platelet-Rich Plasma “PRP”

TROCHLEAR DYPLASIA

The trochlea is a groove in the femur bone underneath the kneecap (patella). The walls of the trochlea stabilize the patella and allow it to glide down the center of the trochlea as the knee bends. It is important for the patella to glide down the middle of the trochlea because a centralized patella increases the strength and efficiency of the quadriceps of the thigh (knee extensor mechanism).

In some individuals, the trochlea does not develop normally. Instead of a groove, some patients have a flat or a dome-shaped trochlea. This condition is called trochlear dysplasia. When an individual has a flat or dome-shaped trochlea, the patella loses stability and can track to the outside of the knee as the knee bends. Individuals with trochlear dysplasia are much more likely to dislocate the patella compared to individuals with a normal trochlea.

Symptoms

  • Achy pain in the front of the knee with squatting and stairs
  • Sense of kneecap slipping or moving out of place

Diagnosis And Treatment

Dr. Keller considers each patient’s symptoms, as well as a detailed physical examination, x-rays, and sometimes an MRI of the knee to make the diagnosis of trochlear dysplasia. Dr. Keller recommends non-surgical management for most patients with trochlear dysplasia. A dedicated physical therapy program is a very important part of the treatment plan. Physical therapy focuses on strengthening of the core muscles, hip muscles, as well as the quadriceps to help stabilize the patella. Other non-surgical treatment options include a stabilizing brace and oral anti-inflammatory medication. In those patients who do not improve with non-surgical management, Dr. Keller may recommend surgical intervention.