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Case: A 75-year-old woman status post total shoulder arthroplasty and posterior rib resection 29 years previously experienced a low-energy intrathoracic scapular dislocation (ISD). Closed reduction under anesthesia was unsuccessful, and she required open surgical repair performed by a novel modification of Kibler's technique for medial scapular muscle repair., Conclusion: This case is unique because increased range of motion after successful arthroplasty allowed her shoulder to flex forward enough to result in ISD. Successful surgical repair was performed by a technique previously not described., Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/C493)., (Copyright © 2024 by The Journal of Bone and Joint Surgery, Incorporated.)

Purpose: Trochlear dysplasia is one of the main risk factors for recurrent patellar dislocation. The Dejour classification identifies four categories that can be used to classify trochlear dysplasia. The purpose of this study is to evaluate the inter- and intraobserver reliability of the Dejour classification for trochlear dysplasia. The hypothesis was that both intra- and interobserver reliability would be at least moderate., Methods: This is a cross-sectional, reliability study. Twenty-eight examiners from the International Patellofemoral Study Group 2022 meeting evaluated lateral radiographs of the knee and axial magnetic resonance images from 15 cases of patellofemoral instability with trochlear dysplasia. They classified each case according to Dejour's classification for trochlear dysplasia (A-D). There were three rounds: one with only computed radiograph (CR), one with only magnetic resonance imaging (MRI) and one with both. Inter- and intraobserver reliability were calculated using κ coefficient (0-1)., Results: The mean age of patients was: 14.6 years; 60% were female and 53% had open physis. The interobserver reliability κ probabilities were 0.2 (CR), 0.13 (MRI) and 0.12 (CR and MRI). The intraobserver reliability κ probabilities were 0.45 (CR), 0.44 (MRI) and 0.65 (CR and MRI)., Conclusion: The Dejour classification for trochlear dysplasia has slight interobserver reliability and substantial intraobserver reliability., Level of Evidence: Level I., (© 2024 European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)