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Published on: August 13, 2017
Anteromedial tibial tubercle transfer without bone graft
J P Fulkerson1, G J Becker, J A Meaney
1Department of Orthopaedic Surgery, University of Connecticut School of Medicine, Farmington.
The American Journal of Sports Medicine
|September 1, 1990
Summary
Anteromedial tibial tubercle transfer significantly improves outcomes for patients with patellofemoral pain and articular degeneration. This surgery offers sustained pain relief and improved function, with a low complication rate.
Area of Science:
- Orthopedic Surgery
- Biomechanical Engineering
- Sports Medicine
Background:
- Persistent patellofemoral pain is often associated with patellar articular degeneration.
- Patellar malalignment can exacerbate pain and lead to further joint damage.
- Surgical interventions aim to correct alignment and alleviate pain.
Purpose of the Study:
- To evaluate the long-term subjective and objective outcomes of anteromedial tibial tubercle transfer.
- To assess the impact of continuous passive motion on postoperative stiffness.
- To investigate the biomechanical effects of the procedure on patellofemoral contact pressures.
Main Methods:
- Prospective follow-up of 30 patients undergoing anteromedial tibial tubercle transfer for over 2 years.
- Subjective and objective outcome assessments.
- Analysis of patellofemoral contact pressures in cadaver knees.
- Evaluation of continuous passive motion's effect on stiffness.
Main Results:
- 93% subjective and 89% objective good to excellent results.
- Sustained improvement observed in patients followed for over 5 years.
- 75% good results in patients with advanced patellar arthrosis.
- Continuous passive motion reduced postoperative stiffness.
- No serious complications in 51 consecutive cases.
- Cadaver studies showed reduced patellofemoral contact stress and balanced pressures.
Conclusions:
- Anteromedial tibial tubercle transfer is a mechanically and clinically successful procedure.
- It effectively alleviates intractable pain in patients with malalignment and articular degeneration.
- The procedure allows patients to resume higher activity levels with diminished pain.
- It demonstrates a favorable safety profile with minimal serious complications.
