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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

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Three-Dimensional Tibial Tubercle Transfer Planning.

John Fulkerson¹, Nancy Park¹, Armita R Manafzadeh¹

¹Yale University Departments of Orthopedic Surgery and Mechanical Engineering, New Haven, Connecticut, USA.

Video Journal of Sports Medicine

|November 3, 2025

Summary

This summary is machine-generated.

Three-dimensional imaging improves tibial tubercle transfer planning for patellar instability. New metrics like EP-TG and EP-TP angles enhance surgical accuracy, optimizing patellar tracking and reducing dislocation risk.

Keywords:

3-dimensional imaging patella tibial tubercle osteotomy tibial tubercle transfer trochleaplasty

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Four-Dimensional CT Analysis Using Sequential 3D-3D Registration

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Published on: November 23, 2019

Area of Science:

Orthopedic surgery
Biomedical imaging
Knee biomechanics

Background:

Traditional 2-D methods for tibial tubercle transfer planning lack accuracy.
3-D imaging offers a more precise approach to surgical planning for patellar instability.

Purpose of the Study:

To develop and validate novel 3-D metrics for improved tibial tubercle transfer planning.
To enhance the understanding of patellar tracking in relation to trochlear anatomy.

Main Methods:

Creation of 3-D CT reconstructions of patient knees at 0° and 20° flexion.
Measurement of novel Entry Point-Trochlear Groove (EP-TG) and Entry Point-Transition Point (EP-TP) angles.
Determination of 3-D Tibial Tubercle-Trochlear Groove (TT-TG) distance, Caton-Deschamps (C-D) ratio, and heat map contours.

Main Results:

New 3-D metrics (EP-TG, EP-TP) objectify patellar tracking paths.
Integration of 3-D metrics with traditional measures (TT-TG, C-D ratio) refines surgical planning.
A 'winter sports' approach visualizes and plans for patellar tracking to prevent dislocation.

Conclusions:

3-D trochlear analysis provides enhanced objectivity for tibial tubercle transfer planning.
Improved visualization of the patellar path aids in surgical adjustments for stable tracking.
3-D planning and custom guides can optimize tibial tubercle osteotomy for patellar instability treatment.