Distal Realignment (Tibial Tuberosity Transfer)

Feller, Julian A.

doi:10.1097/jsa.0b013e318262e8e7

Cited by 19 publications

(18 citation statements)

References 53 publications

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“…18 The direction and the amount of transfer following tibial tubercle osteotomy depend on the patella height and the TTTG. 19 The patella height is best assessed using CDI, whereas the TTTG can be assessed using either a computed tomography or MRI scans. Some investigators consider MRI scan as the gold standard.…”

Section: Discussionmentioning

confidence: 99%

Combined Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle Transfer Results at a Follow-Up of 2 years

Ahmad¹,

Calciu²,

Jayasekera³

et al. 2016

J Knee Surg

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There is limited data on the effectiveness of combined medial patellofemoral ligament (MPFL) reconstruction and tibial tubercle transfer (TTT) in patients with patella instability. The aim of our study was to analyze the functional outcome in patients treated with MPFL reconstruction and TTT. Between July 2008 and April 2013, 18 patients (21 knees) underwent combined MPFL reconstruction and TTT; 15 patients (16 knees) with a mean age of 24 years (16-41) had a mean follow-up of 30 months (26-55). There was significant improvement in outcome scores in 12 out of 15 patients. KOOS score improved from 68.25 (44-93.9) to 77.05 (48.8-96.4) and KUJALA score improved from 63.3 (41-88) to 78.06 (45-99). Nine patients achieved at least a preinstability level of activity. Out of these nine patients, four had activity level better than the preinstability level. The remaining six patients had a lower activity level than preinstability level (2-lack of confidence and 4-lifestyle modification). Fourteen patients were satisfied and happy to recommend this procedure. There were three postoperative complications, with two cases of stiffness and one case of nonunion of the tibial tuberosity. Thus, the restoration of tibial tubercle to trochlear groove distance, patella height, and MPFL reconstruction yields good results in carefully selected patients.

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Section: Discussionmentioning

confidence: 99%

Combined Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle Transfer Results at a Follow-Up of 2 years

Ahmad¹,

Calciu²,

Jayasekera³

et al. 2016

J Knee Surg

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“…3 Se han descrito múltiples procedimientos de realineación distal, que incluyen osteotomía de la tuberosidad anterior para medializar, anteromedializar, distalizar o combinar distalización y medialización. [4][5][6][7][8] El objetivo de estos procedimientos es la corrección de la mala alineación subyacente del mecanismo extensor, que se manifiesta con un aumento de la distancia TT-TG (tuberosidad tibial-surco troclear) de la altura de la rótula. Si bien la restauración de la anatomía del aparato extensor suele arrojar resultados clínicos favorables, el conjunto de técnicas disponibles no están exentas de complicaciones.…”

Section: Introductionunclassified

Osteotomía de la tuberosidad anterior de la tibia en adolescentes y adultos jóvenes: resultados funcionales y complicaciones. [Anterior tibial tubercle osteotomy in adolescents and young adults: functional results and complications]

Masquijo¹,

Bordón²,

Minig³

et al. 2019

Rev. Asoc. Arg. Ort. y Traumatol

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Introducción: La osteotomía de la tuberosidad anterior de la tibia (O-TAT) es una técnica quirúrgica que permite restablecer la alineación distal de la rótula en pacientes esqueléticamente maduros. Los objetivos de este estudio fueron evaluar los resultadosfuncionales y analizar factores que influyeron en el desarrollo de complicaciones.Materiales y Métodos: Se analizaron retrospectivamente pacientes con O-TAT tratados entre 2008 y 2016. Se documentaron datos demográficos y clínicos. Los resultados fueronevaluados según las escalas de Kujala y Tegner-Lysholm, y las complicaciones, con una adaptación de la clasificación de Clavien-Dindo.Resultados: Se analizaron 33 O-TAT en 29 pacientes (17 mujeres). Mediana de la edad: 18 años (RIC 2, mín.-máx. 14-39). Mediana de seguimiento: 49 meses (RIC 2, mín.-máx. 12-115). Mejoría en las escalas de Kujala y Tegner-Lysholm de 61 y 61,5 a 94 y 92,3, respectivamente (p = 0,001). La mediana de tiempo de consolidación fue de 8 semanas. Hubo 9 complicaciones (27%): 1 grado II (infección superficial) y 8 grado III (artrofibrosis, fracturas de tibia y fracturas de TAT, n = 2). La tasa de complicaciones fue más alta en los pacientes sometidos a desinserción de la TAT (51,5% vs. 11,1%, p = 0,029).Conclusiones: La O-TAT representa una técnica eficaz para tratar diversas patologías de la articulación patelofemoral en adolescentes y adultos jóvenes. Hubo complicaciones en un alto porcentaje de los procedimientos, sin que esto afectara el resultado final. El riesgo de complicaciones fue mayor en las osteotomías que requirieron desinserción de la TAT y la reconstrucción ligamentaria. ABSTRACTIntroduction: Tibial tubercle osteotomy (TTO) is a surgical approach that allows for the restoration of distal patellar alignment in skeletally mature patients. The objectives of this study were to evaluate functional results and to analyze the risk factors associated with complications. Methods: We carried out a retrospective analysis of patients subjected to a TTO between 2008 and 2016 and documented demographic and clinical data. Results were evaluated according to the Kujala Anterior Knee Pain Scale and the Tegner-Lysholm Knee Scoring Scale. Complications were evaluated with a modified Clavien-Dindo Classification of Surgical Complications. Results: We evaluated 33 TTOs in 29 patients (17 women) with a median age of 18 years (IQR 2, range: 14-39) and a median follow-up time of 49 months (IQR 2, range: 12-115). The Kujala and the Tegner-Lysholm scoring improved from 61 and 61.5 to 94 and 92.3, respectively (p=0.001). Union was achieved at a median of 8 weeks. There were 9 complications (27%): a grade II complication (superficial infection) and 8 grade III complications (arthrofibrosis, tibial fractures, and anterior tibial tubercle fractures). Osteotomies in which the tibial tubercle was completely detached had a significantly higher rate of complications (51.5% vs. 11.1%, p=0.029). Conclusions: TTO represents an effective approach for the treatment of several conditions of the patellofemoral joint in adolescents and young adults. In our series, a high percentage of the procedures presented complications, although they did not affect the final result. Osteotomies that involve complete detachment of the tubercle and those associated with ligament reconstruction have an increased risk of complications.

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“…In addition to soft-tissue restraints, malalignment in the form of pathologic lateralization of the tibial tubercle (TT)dmeasured as the increased tibial tubercleetrochlear groove (TT-TG) distance (as measured on computed tomography scan or magnetic resonance imaging)dcan contribute to lateral patellar instability. [10][11][12] Excessive lateral positioning of the TT increases the lateral force vectors on the patella. 11 Multiple studies have reported the normal TT-TG distance to be less than 13 mm, abnormal to be greater than 15 mm, and pathologic to be greater than 20 mm.…”

mentioning

confidence: 99%

“…[10][11][12] Excessive lateral positioning of the TT increases the lateral force vectors on the patella. 11 Multiple studies have reported the normal TT-TG distance to be less than 13 mm, abnormal to be greater than 15 mm, and pathologic to be greater than 20 mm. 10,11,13,14 Although significant focus has been placed on patellofemoral instability in recent years, it was Goldthwait 15 who first described the etiology of patellofemoral instability in 1903, and he ultimately concluded that nonoperative management was not effective.…”

mentioning

confidence: 99%

“…11 Multiple studies have reported the normal TT-TG distance to be less than 13 mm, abnormal to be greater than 15 mm, and pathologic to be greater than 20 mm. 10,11,13,14 Although significant focus has been placed on patellofemoral instability in recent years, it was Goldthwait 15 who first described the etiology of patellofemoral instability in 1903, and he ultimately concluded that nonoperative management was not effective. After lackluster results with attempts at medial retinacular plication, he performed a distal realignment procedure with "perfect" results.…”

mentioning

confidence: 99%

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Medial Patellofemoral Ligament Reconstruction With Concomitant Tibial Tubercle Transfer: A Systematic Review of Outcomes and Complications

Burnham

Howard

Hayes

et al. 2016

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Distal Realignment (Tibial Tuberosity Transfer)

Cited by 19 publications

References 53 publications

Combined Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle Transfer Results at a Follow-Up of 2 years

Combined Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle Transfer Results at a Follow-Up of 2 years

Osteotomía de la tuberosidad anterior de la tibia en adolescentes y adultos jóvenes: resultados funcionales y complicaciones. [Anterior tibial tubercle osteotomy in adolescents and young adults: functional results and complications]

Medial Patellofemoral Ligament Reconstruction With Concomitant Tibial Tubercle Transfer: A Systematic Review of Outcomes and Complications

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