20Shoulder Care
AC Joint Injuries
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
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
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
17Hip Care
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Labral Tears
Psoas Impingement (Internal Snapping Hip)
Trochanteric Bursitis
Gluteal Repair
Labral Debridement
Labral Repair
Labral Reconstruction
Trochanteric Bursa Debridement
Bone Marrow Aspirate Stem Cell Concentrate (BMC)
Platelet-Rich Plasma “PRP”



The kneecap (patella) is a small bone in the front of the knee that helps support the extensor mechanism (quadriceps and patellar tendons). As the knee bends, the patella glides along a groove on the femur bone – the trochlea. Patellar instability refers to a condition in which the patella slides out of the trochlea (dislocates). Some individuals have a shallow trochlear groove (a flat trochlea). When the trochlear groove is shallow or flat, the patella is unstable as the knee bends and can slip out of place (dislocate). In those patients who do not improve with non-surgical management, Dr. Keller may recommend surgical intervention.


The goal of trochleoplasty is to create a deeper trochlea to stabilize the patella. During surgery, Dr. Keller makes an incision adjacent to the patella and identifies the trochlea. Using guide pins, Dr. Keller then makes cuts in the femur bone (around the trochlea) and repositions the cartilage and bone into a deep, V-shape. Dr. Keller is careful to deepen the groove enough to stabilize the patella. Usually, patients who require a trochleoplasty require an additional procedure, such as an MPFL reconstruction, to fully stabilize the patella.


Post-Operative Rehabilitation


Following surgery, full weight-bearing is encouraged with the knee locked in a brace in the extended position. Dr. Keller also recommends intermittent icing, straight leg raises for quad strength, and starting a dedicated physical therapy protocol one week after surgery. The physical therapist focuses on reducing swelling in the knee, range of motion, and restoring strength to the limb and core. Dr. Keller recommends advancing the physical therapy program to cutting, pivoting, and sport-specific activities approximately four months after surgery. Most patients return to competitive sports approximately six months after surgery. It is very important to follow the rehabilitation process carefully to achieve the best outcome.