Sulcus-deepening trochleoplasty is a valid option for the primary surgical treatment of carefully selected patients with recurrent patellar dislocations with high-grade trochlear dysplasia type B and D. Concomitant etiological factors must be cautiously corrected in an associated procedure. Midterm follow-up showed satisfactory restoration of patellar stability and improvement of knee scores with no complication of subsequent arthritis.

Trochlear dysplasia is a key factor in the treatment of recurrent patellar dislocation and its correction could be included in the surgical options. Sulcus-deepening trochleoplasty is an acceptable revision option for the surgical treatment of patients with persisting patellar dislocation and high-grade trochlear dysplasia.

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AIMS: The Pixee Knee+ system offers intraoperative assistance through augmented reality glasses. This allows the surgeon to see the tibial and femoral axis depicted on the surgical field, providing real-time information during surgery.METHODS: 122 patients received TKA surgery with the Pixee Knee+ system, and were matched based on gender and age to 122 patients who received conventional surgery. PROMs (Oxford knee Score, KOOS, and Forgotten Joint score) were collected preoperatively, at 6 weeks and 3 months. The difference between the scores at 6 weeks versus preoperative (Delta) was analyzed over time of surgery, in order to evaluate any possible surgeon learning curve.RESULTS: Pixee patients scored significantly lower on the symptoms sub-scale of the KOOS score at 6 weeks. Similarly, at 3 months, the Quality of life sub-score, Forgotten Joint score and Oxford Knee Score were all significantly worse for the Pixee group. When analyzing the Delta KOOS over time, a clear increase in the linear model could be established for the Pixee group, whereas the Delta KOOS outcomes in the conventional group remained at a plateau.CONCLUSION: The use of the Pixee Knee+ system results in an initial inferior clinical outcome when comparing the average of the two groups. This is likely explained by a learning curve, which shows an increase over time of the Delta KOOS at 6 weeks in the Pixee group. To what extent this increase over time will persist remains to be investigated

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