Tibial Tubercle Transfer

Tibial tubercle osteotomy is a surgical procedure undertaken to correct the alignment of the patella in patients where appropriate physiotherapy has failed to resolve the problem. Problems associated with malalignment and subsequent maltracking of the patella include:

  • Patella Instability (Dislocation or Subluxation)
  • Patella Pain (Anterior knee pain)
  • Patella Osteoarthritis

Surgery

Tibial Tubercle Osteotomy is generally carried out as either a day case procedure or a single overnight stay in hospital. The procedure is performed under general anaesthesia. An initial knee arthroscopy may be carried out to assess the inside of the knee, evaluate the patella cartilage and patella tracking. Your surgeon then carries out a longitudinal incision about 8cm in length over the tibial tubercle. Using a surgical saw and osteotomes either partially or fully detaches the tibial tuberosity. The tuberosity can then be repositioned to correct the malalignment and is then fixed in its new position with two bone screws. The wound is closed with sutures and a dressing applied.

Post Operative Care

You will have mild to moderate knee discomfort and swelling for a few days or weeks. Keep the leg elevated and apply ice for 20 minute intervals. Oral pain killers will be prescribed.? A knee brace is fitted and the you will be mobilised with crutches. Weight bearing as comfort allows is generally permitted. Crutches will be required for a period of six weeks. A post operative physiotherapy program by an experienced physiotherapist is essential. Full recovery from this procedure may take up to 6 months. The screws used for fixation of the tibial tubercle are generally removed 3 – 6 months post operatively.

Complications

As with any surgery there are potential risks although they are small. The risks include:

  • Infection
  • Compartment Syndrome
  • Deep vein thrombosis / embolism
  • Delayed bone healing
  • Difficulty in kneeling on the operated knee

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