The Incidence of Complications of Tibial Tubercle Osteotomy: A Systematic Review

Payne, Joshua; Rimmke, Nathan; Schmitt, Laura C.; Flanigan, David C.; Magnussen, Robert A.

doi:10.1016/j.arthro.2015.03.028

Cited by 121 publications

(142 citation statements)

References 31 publications

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“…From our data, we cannot confirm this theoretical concept in practice. Compared to the non-union rate of 0.8% in the 787 TTO's published by Payne et al [6] in their systematic review, the incidence in our group (0.38%) is even lower. This could be due to the bigger contact area of the V-shaped osteotomy with the trabecular bone for better bone healing (Fig.…”

Section: Discussioncontrasting

confidence: 76%

“…Several types of osteotomies are described: the modified Elmslie-Trillat medialisation technique [2], the Fulkerson anteromedialisation technique [3], a sliding TTO [4], and techniques in which the tibial tuberosity is completely detached [5]. A systematic review by Payne et al concluded that the risk of complications is related to the employed technique [6]. In their review, the complication rate lies between 3.3 and 10.7%.…”

Section: Introductionmentioning

confidence: 99%

“…Also, the theory of creating a tibial stress fracture when using a step-cut osteotomy lives among surgeons [10]. Payne et al stated that osteotomies that involve complete detachment of the tubercle have an increased risk of non-union and tibial fractures compared with those in which a distal cortical hinge is maintained [6].…”

Section: Introductionmentioning

confidence: 99%

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A detaching, V-shaped tibial tubercle osteotomy is a safe procedure with a low complication rate

Rood

Sambeeck

Koëter

et al. 2020

Arch Orthop Trauma Surg

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Introduction In patients with recurrent patellar dislocations, a tibial tubercle osteotomy (TTO) can be indicated to correct patella alta or an increased trochlear groove-tibial tubercle distance. Several surgical techniques are described. Previous studies emphasize that detaching osteotomies results in devascularisation, which can lead to non-union and tibial shaft fractures. The aim of this study was to report the complication rates directly related to the surgical technique of a V-shaped TTO, where the tubercle is completely released from its periosteum using a step-cut osteotomy. Methods The retrospective case series comprised a large cohort of 263 knees with patella alta in 203 patients who underwent a V-shaped TTO, with or without additional realignment procedures, between March 2004 and October 2017. Data were obtained from available patient files. Complications were defined as minor or major. Results Thirteen major complications were registered (4.9%) including two tibial fractures (0.75%) and one non-union (0.37%). Five complications (1.9%) were defined as minor. Removal of the screws because of irritation or pain was seen in 22 cases (8.2%). Conclusion A V-shaped TTO is a safe procedure. The presumed higher risk for tibial fractures or pseudo-arthrosis could not be confirmed.

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Section: Discussioncontrasting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

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A detaching, V-shaped tibial tubercle osteotomy is a safe procedure with a low complication rate

Rood

Sambeeck

Koëter

et al. 2020

Arch Orthop Trauma Surg

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“…22 These points could be issues with other techniques such as complete osteotomy of the anterior tibial tubercle that presents the possibility of nonunion or an iatrogenic change in the Q angle. 23 Furthermore, our technique does not require any autografts and needs few and inexpensive devices to fix the tendon. The patient is positioned supine on the operating table, with 90 of knee flexion, using a distal foot support and a lateral support for the thigh.…”

Section: Discussionmentioning

confidence: 99%

Patellar Tendon Lengthening: Rescue Procedure for Patella Baja

Perelli

Ibáñez

Marin

et al. 2020

Arthroscopy Techniques

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Patella baja is a challenging pathologic condition that causes pain and functional restrictions and can even lead to premature osteoarthritisdeven more so in cases of patella infera or cases associated with degeneration of the patellar tendon in which simple conservative treatment frequently is not resolutive. Several surgical options have been described for symptomatic patella baja: excision of the lower third of the patella, lengthening of the patellar tendon, reconstruction of the patellar tendon with allograft, and proximalization of the tibial tubercle. A combination of 2 or more of these treatments may be recommended in cases of significant patella baja. We present a simple and reproducible technique to address patella baja that combines a partial transposition of the tibial tubercle and patellar tendon lengthening using a subperiosteal patellar flap in continuity with the patellar tendon.

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“…These techniques should be considered when recurrences are caused by skeletal deformities related to malalignment of the extensor apparatus. Bone realignments allow the correction of patellar "maltracking", and the management of symptoms associated to this condition [120][121][122] .…”

Section: Tibial Tubercle Osteotomymentioning

confidence: 99%

I.S.Mu.L.T. first-time patellar dislocation guidelines

Vetrano

Oliva

Bisicchia

et al. 2017

MLTJ

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SummaryPrimary traumatic patellar dislocation is common, particularly in young active individuals. A consensus on its management is still lacking. The present work provides easily accessible guidelines to be considered as recommendations for a good clinical practice developed through a process of systematic review of the literature and expert opinion, to improve the quality of care and rationalize the use of resources. Level of evidence: Ia.

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The Incidence of Complications of Tibial Tubercle Osteotomy: A Systematic Review

Cited by 121 publications

References 31 publications

A detaching, V-shaped tibial tubercle osteotomy is a safe procedure with a low complication rate

A detaching, V-shaped tibial tubercle osteotomy is a safe procedure with a low complication rate

Patellar Tendon Lengthening: Rescue Procedure for Patella Baja

I.S.Mu.L.T. first-time patellar dislocation guidelines

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