Jordy van Sambeeck

Chapter 1 24 Chapter 4 reports the rate of complications of a V-shaped TTO in a case series of 263 procedures. This is an essentially different technique, where the tibial tubercle is completely released from its periosteum using a V-shaped step-cut osteotomy. Trochleoplasty (Chapter 5, 6, 7) 4. What is the effect of age on patient reported outcome after a lateral facet elevating trochlear osteotomy? (Chapter 5) 5. Do the clinical and radiological results of a lateral facet elevating trochlear osteotomy deteriorate in patients with a minimum of 12 year follow-up? (Chapter 6) 6. What is the rate of complications after various techniques used for trochleoplasty? (Chapter 7) The lateral facet elevating trochlear osteotomy is historically one of the first described techniques of trochleoplasty. Concerns exist about the long term results of this procedure, it might lead to early patellofemoral osteoarthritis. This could be even more pronounced for older patients, because they are expected to have less pliable osteocartilaginous structures. In Chapter 5 we analyzed the effect of age on patient reported outcome of this type of trochlear osteotomy in a large cohort of 113 cases. In Chapter 6 we describe the clinical and radiological results of this surgical technique in patients with a minimum of 12 year follow-up. Most articles on other trochleoplasty techniques present satisfactory results, although the outcome measures vary widely. However, complications are often not included as primary outcome measure. Chapter 7 assesses the rate of complications after various techniques used for trochleoplasty procedures. A systemic review of literature and a meta-analysis was performed. This provides more knowledge on complications after these procedures. Outcome measurement (Chapter 8) 7. Are the translated Banff Patellar Instability Instrument and Norwich Patellar Instability score valid patient reported outcome measurements? (Chapter 8) Outcome in terms of patellofemoral stability, patellofemoral osteoarthritis or complications are relatively easy to measure or document. However, it is clear that focusing on these ‘objective’ outcomes neglects the ‘subjective’ outcome experienced by the patient. So far, there is not a recipe to achieve an ‘objective’ good outcome that is a guarantee for a ‘subjective’ happy patient. To evaluate this more subjective outcome, patient reported outcome measures (PROMs) can be used. In previous years, two new English PROMs have been developed specifically for patients with patellofemoral disorders. In Chapter 8 we translated these PROMs to Dutch language. Then, they were validated in patients who have undergone surgical treatment for patellar instability.