الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The importance of dysplastic trochlea to be constituent of unstable sesamoid bone of the knee (especially recurrent dislocation or habitual dislocation) is known for many years. It is usually combined with other static or dynamic abnormal findings as genu recurvatum, patella alta, patellar tilt, increased Q angle and bone torsional abnormalities,It is characterized by the combination of a flat and/or prominent trochlea proud of the anterior femoral cortex which offer inadequate tracking during flexion and leads the sesamoid bone of the knee to sublux.Patellofemoral alignment refers to the static relationship between the patella and the trochlea at a given degree of knee flexion.
Tracking refers to dynamic patellofemoral alignment during knee motion. The resultant patellofemoral compression force is due to component of the force in quadriceps and patellar tendon, which are perpendicular to the articular surface of patellofemoral joint. This component holds the patella in contact with the femur, so the resultant patellofemoral force depends on two factors(39):1- Knee flexion angle. 2- Forces in the patellar and quadriceps tendons.In the big major part of cases , Repair of the femoral trochlea done in combination with other procedures (bone techniques such as AnTTT repositioning, or soft tissue procedure such as medial patella-femoral ligament reshaping. These coupled ways follows the thought of ”a la carte” surgery described by Henri and David Dejour.