Technical Considerations for an Anteromedializing Tibial Tubercle Osteotomy
Background: Tibial tubercle osteotomy and distal realignment allows for adjustment to the patellofemoral articulation in order to improve patellar tracking and redistribute patellar contract pressures. Indications: A healthy, active 39-year-old woman status post right knee tibial tubercle osteotomy...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2021-10-01
|
| Series: | Video Journal of Sports Medicine |
| Online Access: | https://doi.org/10.1177/26350254211045994 |
| _version_ | 1818723672974688256 |
|---|---|
| author | Thomas E. Moran MD Anthony J. Ignozzi BS Scott Dart MD David R. Diduch MD |
| author_facet | Thomas E. Moran MD Anthony J. Ignozzi BS Scott Dart MD David R. Diduch MD |
| author_sort | Thomas E. Moran MD |
| collection | DOAJ |
| description | Background: Tibial tubercle osteotomy and distal realignment allows for adjustment to the patellofemoral articulation in order to improve patellar tracking and redistribute patellar contract pressures. Indications: A healthy, active 39-year-old woman status post right knee tibial tubercle osteotomy presented with >2 years of patellar instability symptoms in the left knee. Imaging revealed a tibial tubercle to trochlear groove (TT-TG) distance of 21 mm and patellar tendon lateral trochlear ridge (PT-LTR) distance of 14 mm. Technique Description: After knee arthroscopy is performed, an open incision is made along the inferomedial patellar tendon. Two pilot holes are created before a sagittal saw is used to make the tibial tubercle osteotomy, before completing it with an osteotome. Anteromedialization and/or distalization of the osteotomy is performed relative to templated values in order to improve patellar articulation. After correction, 3 bicortical screws are placed to achieve stable fixation. Results: There were no immediate complications following surgery. Surgical management led to improvement of the patient’s patellofemoral pain, which allowed return to prior baseline level of function. Discussion/Conclusion: The preferred technique for an anteromedialzing tibial tubercle osteotomy is presented. An anteromedializing tibial tubercle osteotomy is an effective surgical option for patients with evidence of patellar maltracking or central or lateral patellar chondromalacia whom have failed conservative management. This case demonstrates the efficacy of an anteromedializing tibial tubercle osteotomy to provide pain relief by improving patellar tracking and offloading patellar contact pressures on areas of prominent chondral wear. |
| first_indexed | 2024-12-17T21:14:15Z |
| format | Article |
| id | doaj.art-b881dff224594543994c4f04e0eb50de |
| institution | Directory Open Access Journal |
| issn | 2635-0254 |
| language | English |
| last_indexed | 2024-12-17T21:14:15Z |
| publishDate | 2021-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Video Journal of Sports Medicine |
| spelling | doaj.art-b881dff224594543994c4f04e0eb50de2022-12-21T21:32:23ZengSAGE PublishingVideo Journal of Sports Medicine2635-02542021-10-01110.1177/26350254211045994Technical Considerations for an Anteromedializing Tibial Tubercle OsteotomyThomas E. Moran MD0Anthony J. Ignozzi BS1Scott Dart MD2David R. Diduch MD3Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USADepartment of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USADepartment of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USADepartment of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USABackground: Tibial tubercle osteotomy and distal realignment allows for adjustment to the patellofemoral articulation in order to improve patellar tracking and redistribute patellar contract pressures. Indications: A healthy, active 39-year-old woman status post right knee tibial tubercle osteotomy presented with >2 years of patellar instability symptoms in the left knee. Imaging revealed a tibial tubercle to trochlear groove (TT-TG) distance of 21 mm and patellar tendon lateral trochlear ridge (PT-LTR) distance of 14 mm. Technique Description: After knee arthroscopy is performed, an open incision is made along the inferomedial patellar tendon. Two pilot holes are created before a sagittal saw is used to make the tibial tubercle osteotomy, before completing it with an osteotome. Anteromedialization and/or distalization of the osteotomy is performed relative to templated values in order to improve patellar articulation. After correction, 3 bicortical screws are placed to achieve stable fixation. Results: There were no immediate complications following surgery. Surgical management led to improvement of the patient’s patellofemoral pain, which allowed return to prior baseline level of function. Discussion/Conclusion: The preferred technique for an anteromedialzing tibial tubercle osteotomy is presented. An anteromedializing tibial tubercle osteotomy is an effective surgical option for patients with evidence of patellar maltracking or central or lateral patellar chondromalacia whom have failed conservative management. This case demonstrates the efficacy of an anteromedializing tibial tubercle osteotomy to provide pain relief by improving patellar tracking and offloading patellar contact pressures on areas of prominent chondral wear.https://doi.org/10.1177/26350254211045994 |
| spellingShingle | Thomas E. Moran MD Anthony J. Ignozzi BS Scott Dart MD David R. Diduch MD Technical Considerations for an Anteromedializing Tibial Tubercle Osteotomy Video Journal of Sports Medicine |
| title | Technical Considerations for an Anteromedializing Tibial Tubercle Osteotomy |
| title_full | Technical Considerations for an Anteromedializing Tibial Tubercle Osteotomy |
| title_fullStr | Technical Considerations for an Anteromedializing Tibial Tubercle Osteotomy |
| title_full_unstemmed | Technical Considerations for an Anteromedializing Tibial Tubercle Osteotomy |
| title_short | Technical Considerations for an Anteromedializing Tibial Tubercle Osteotomy |
| title_sort | technical considerations for an anteromedializing tibial tubercle osteotomy |
| url | https://doi.org/10.1177/26350254211045994 |
| work_keys_str_mv | AT thomasemoranmd technicalconsiderationsforananteromedializingtibialtubercleosteotomy AT anthonyjignozzibs technicalconsiderationsforananteromedializingtibialtubercleosteotomy AT scottdartmd technicalconsiderationsforananteromedializingtibialtubercleosteotomy AT davidrdiduchmd technicalconsiderationsforananteromedializingtibialtubercleosteotomy |