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Long-Term Evaluation of the Elmslie-Trillat-Maquet Procedure for Patellofemoral Dysfunction

University of Pennsylvania, Department of Orthopaedic Surgery, Philadelphia, Pennsylvania, University of Pennsylvania, Department of Orthopaedic Surgery, Philadelphia, Pennsylvania

P.J. Reilly, MD

Gate Orthopaedics, Warwick, Rhode Island, Statesville Medical Group, Statesville, North Carolina

Jeffrey R. Kuhlman, MD

Elliott Haut

University of Pennsylvania, Department of Orthopaedic Surgery, Philadelphia, Pennsylvania

Joseph S. Torg, MD

Allegheny University, Philadelphia, Pennsylvania

We evaluated 55 knees in 51 patients after Elmslie- Trillat-Maquet procedures. The procedure involves medialization of the tibial tubercle on a distal pedicle and elevating the tibial tubercle anteriorly 10 mm with a local bone graft. At a mean followup of 74.2 months (range, 13 to 196), all patients completed postopera tive surveys and 38 underwent postoperative exami nations. Subjectively, 9 knees (16%) had excellent results, 24 knees (44%) obtained good results, and 13 knees (24%) had fair results for a total of 84% improve ment overall. Using Fulkerson's functional knee score, 19 knees (35%) had excellent results, 10 knees (18%) had good results, and 11 knees (20%) had fair results for a total of 73% improvement overall. A total of 24 knees (44%) required later screw removal. The most significant findings of this study include 1) an 84% overall subjective improvement in symptoms; 2) the findings that young patients without evidence of pro gressive osteoarthrosis and with patella instability as a primary symptom tend to have the most favorable out come ; and 3) 24 knees (44%) required later screw removal.

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