Current evidence on the safety and efficacy of arthroscopic trochleoplasty for patellar instability is inadequate in quantity and quality. Therefore this procedure should only be used with special arrangements for clinical governance, consent and audit or research.
Clinicians wishing to undertake arthroscopic trochleoplasty for patellar instability should take the following actions:
Inform the clinical governance leads in their NHS trusts.
Ensure that patients understand the uncertainty about the procedure's safety and efficacy and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having arthroscopic trochleoplasties (see NICE's interventional procedure outcomes audit tool).
Patient selection should be done by surgeons with expertise in managing patellar instability.
The procedure should be undertaken by surgeons with experience in open trochleoplasty and in arthroscopic procedures on the knee.
NICE encourages further research into arthroscopic trochleoplasty for patellar instability, including publication of consecutive patient series. Patient selection should be described in detail. Reported outcomes should include functional and quality‑of‑life measures, as well as reoperation rates.