Tibial Tubercle Osteotomy: Technique for Anteromedialization and Distalization

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Surgical Techniques

Background:

• Tibial tubercle osteotomy is a recognized surgical technique for managing patellofemoral overload and instability.
• Indications include patellofemoral instability, stress reactions, excessive lateral tuberosity position, or abnormal patellar height.

Purpose of the Study:

• To present and describe anteromedialization and distalization techniques for tibial tubercle osteotomy.
• To highlight the biomechanical benefits of these osteotomies in reducing patellofemoral joint forces.

Main Methods:

• Demonstration of two tibial tubercle osteotomy techniques: anteromedialization alone and combined distalization with anteromedialization.
• Procedures were performed on cadaveric models to illustrate surgical steps.

Main Results:

• Biomechanical studies indicate that anteromedialization and/or distalization decrease patellofemoral joint forces compared to native or lateralized positions.
• These osteotomies offer a customizable approach to optimize patellofemoral alignment.

Conclusions:

• Anteromedializing and distalizing tibial tubercle osteotomies are reproducible procedures valuable for patellofemoral surgeons.
• Careful preoperative planning and intraoperative technique are essential for successful outcomes with these customizable osteotomies.