Editorial Commentary: Trochlear Dysplasia: Can We Change its Natural History or Degenerative Prognosis?

Trochlear dysplasia may be asymptomatic and benign, or could engender patellar instability and degenerative arthritis. Autologous chondrocyte implantation is demonstrating promising outcomes for the treatment of patellofemoral cartilage lesions, but may not suffice for knees with underlying mechanical anomalies as trochlear dysplasia, where adjuvant trochleoplasty or tibial tubercle osteotomy may be required to prevent patellofemoral instability and to protect the graft from wear and damage. Rigorous radiographic assessment is important to discern the type of dysplasia, notably the presence of a potentially pathogenic supra-trochlear spur. Trochleoplasty or other realignment procedures such as tibial tubercle osteotomy should be considered where necessary to correct underlying trochlear deformities and thereby avoid iatrogenic complications or failure.