Revisiting Fulkerson's Original Technique for Tibial Tubercle Transfer: Easing Technical Demand and Improving...

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Patellofemoral Joint Disorders

Background:

• Tibial tubercle osteotomy (TTO) is a recognized surgical procedure for managing patellofemoral pain syndrome and other related conditions.
• Various TTO techniques exist, involving anteriorization, medialization, and distalization of the tibial tubercle to address specific biomechanical issues.
• These procedures demand meticulous preoperative planning and precise surgical execution to prevent complications and ensure successful correction.

Purpose of the Study:

• To present a refined technique for tibial tubercle osteotomy using medial-to-lateral guide pins.
• To highlight the advantages of this technique in achieving accurate osteotomy angles and versatile tubercle repositioning.
• To demonstrate a method that allows for the preservation of a distal cortical hinge when desired.

Main Methods:

• The described technique utilizes osteotomy guide pins inserted from a medial to lateral direction.
• This approach, adapted from Fulkerson's 1982 method, facilitates enhanced visualization of the osteotomy angle.
• The technique offers flexibility for various combinations of anteriorization, medialization, and distalization of the tibial tubercle.

Main Results:

• Improved intraoperative visualization aids in confirming the osteotomy angle.
• The medial-to-lateral pin insertion allows for versatile repositioning of the tibial tubercle.
• The technique provides the option to maintain a distal cortical hinge, potentially enhancing stability.

Conclusions:

• This modified tibial tubercle osteotomy technique offers enhanced visualization and versatility.
• It provides surgeons with a reliable method for accurate correction of patellofemoral disorders.
• The technique's adaptability and potential for preserving a cortical hinge contribute to its clinical utility.