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Related Concept Videos

Bones of the Lower Limb: Tibia and Fibula01:10

Bones of the Lower Limb: Tibia and Fibula

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The tibia is the main weight-bearing bone of the lower leg. It is larger than the fibula with which it is paired. The tibia is also the second longest bone in the body and is located right below the skin. The proximal end of the tibia forms the medial and the lateral condyle, which articulates with the condyles of the femur to form the knee joint. Between the articulating surfaces is the irregular elevated area known as the intercondylar eminence that serves as the inferior attachment point for...
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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Related Experiment Video

Updated: Jan 17, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Tibial Tubercle Anteriorization and Distalization Using the Multi-Directional Tibial Tubercle Transfer (MD3T) System.

Ran Atzmon1,2, Adam Wadsworth1,3, Anna Bartsch1,4

  • 1Department of Orthopaedic Surgery, Stanford University, Redwood City, California, USA.

Video Journal of Sports Medicine
|September 25, 2025
PubMed
Summary
This summary is machine-generated.

The Multi-Directional Tibial Tubercle Transfer (MD3T) system offers precise, customizable tibial tubercle osteotomy (TTO) for patellofemoral joint issues. This innovative system enhances surgical accuracy and patient outcomes by enabling multiplanar corrections with reduced risks.

Keywords:
Multi-Directional Tibial Tubercle Transfer (MD3T) systemanteriorizationdistalizationpatellar instabilitytibial tubercle osteotomy

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Area of Science:

  • Orthopedic Surgery
  • Biomechanics
  • Biomedical Engineering

Background:

  • Tibial tubercle osteotomy (TTO) is crucial for improving patellofemoral joint (PFJ) contact and reducing abnormal forces.
  • Current TTO techniques like anteromedialization (AMZ) have limitations in isolated planar adjustments and may exacerbate medial cartilage lesions.
  • The Multi-Directional Tibial Tubercle Transfer (MD3T) system introduces enhanced precision and modularity for TTO.

Purpose of the Study:

  • To evaluate the MD3T system's capability for precise, customizable tibial tubercle realignments.
  • To assess the MD3T system's potential to address various PFJ pathologies through anteriorization and distalization.
  • To compare the MD3T system's advantages over traditional TTO techniques regarding precision and safety.

Main Methods:

  • The MD3T system utilizes a proprietary wedge system for uniplanar or multiplanar corrections.
  • Specialized saw guides facilitate accurate osteotomy cuts.
  • Bone void fillers are used for tubercle repositioning (anteriorization or distalization), preserving cortical integrity.

Main Results:

  • The MD3T system enables precise anteriorization and distalization of the tibial tubercle.
  • It preserves both cortices and minimizes the need for extensive anterior compartment dissection.
  • This approach reduces the risk of iatrogenic neurovascular injuries.

Conclusions:

  • The MD3T system simplifies TTO by providing consistent, precise multiplanar corrections.
  • Its wedge technique preserves cortical structures and reduces neurovascular injury risk, enhancing surgical efficiency.
  • The MD3T system facilitates reconstruction of favorable knee biomechanics for improved patient outcomes.