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

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 postoperative surveys and 38 underwent postoperative examinations. 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% improvement 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 progressive osteoarthrosis and with patella instability as a primary symptom tend to have the most favorable outcome; and 3) 24 knees (44%) required later screw removal.