Modified technique for tibial tubercle elevation with realignment for patellofemoral pain. A preliminary report

Malalignment of the quadriceps mechanism was corrected and the tibial tuberosity elevated in 17 knees in 16 patients without the use of a free bone graft. The indications for operation were patellofemoral pain unresponsive to conservative treatment, recurrent subluxation or dislocation of the patella, and patients who had had a previous patellectomy with subsequent lateral subluxation of the patella tendon associated with pain. A bone block including the attachment of the patellar tendon is transposed medially to correct the quadriceps angle (Q-angle), elevate the tibial tuberosity, and thereby decrease patellofemoral pressure. A prerequisite for this procedure is a Q-angle of 20 degrees or more. The average age of the patients was 29 years. The follow-up period was one to four years. Eighty-five percent of the patients had an excellent or good result. The only complication was a stress fracture, which developed in one bone block.