Tibial tubercle osteotomy is a common treatment option for a number of patellofemoral joint disorders including chondromalacia, “anterior knee pain” syndromes, patellofemoral arthritis, and patellar instability. Tibial tubercle osteotomy can modify tracking and/or patellofemoral contact forces to effect the unloading of chondral defects of the patella or trochlea, correct multiplanar suboptimal alignment, and be used in conjunction with soft-tissue stabilization procedures for instability. The purpose of this Technical Note is to describe, in detail, a modified osteotomy for anteromedialization of the tibial tubercle. The technique combines the concepts of Elmslie-Trillat and Fulkerson and modifies their techniques to produce an osteotomy that decreases lateral patellar pressure and centers the patella correctly in the trochlear groove.

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Apply it!• Gain a better understanding of the purpose of occlusion training, how to properly utilize it, and when to use it with your clients.• Understand the contraindications to occlusion training and know some of the possible health risks associated with it.