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SURGERY
Surgical repair most often utilizes a combination of soft
tissue and bone repair to reposition the patella in the
trochlear groove. The trochlear groove can then be
deepened using one of the many described techniques
for a trochlearplasty. Only techniques that salvage the
hyaline cartilage in the trochlear groove should be used.
Newer methods of creating a deeper trochlear groove
have been developed in recent times. These consist of
RidgeStop™ developed by Orthomed UK (Fig 3).
This uses a high-density polyurethane implant placed
on the medial trochlear ridge to aid in the treatment of
patella luxation. The current recommendation is that is
should only be used alone in cases of mild patella lux-
ations with no marked bone deformity of the leg. It can
be used together with the bone corrective techniques to
augment repair.
The RidgeStop™ offers a less invasive method to deepen
the patella groove to aid in movement of the patella in
the normal alignment. It does not require the removal
of a cartilage wedge to deepen the groove but does re-
quire accurate placement of 3 bone screws in the medial
condyle to secure the implant. Kyron have developed an
entire groove replacement made from titanium that the
patella slides in. The author has no experience with this
technique.
Figure3a: A jig is used to pre-place screws
The disadvantage to both these techniques is the in-
creas