Editorial Commentary: Tibial Tubercle Osteotomy Complications Are Most Common With Complete Detachment of the Distal Periosteal Hinge

2015 ◽  
Vol 31 (9) ◽  
pp. 1826 ◽  
Author(s):  
James H. Lubowitz
Keyword(s):  
Tibial Tubercle ◽  
Tibial Tubercle Osteotomy ◽  
Editorial Commentary ◽  
Complete Detachment

scholarly journals 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]

2019 ◽  
Vol 84 (1) ◽  
pp. 27-34
Author(s):  
Julio Javier Masquijo ◽  
Marcio Esteban Bordón ◽  
Mauro Minig ◽  
Aidee Vázquez Aguilar ◽  
Armando Torres-Gómez ◽  
...  
Keyword(s):  
Young Adults ◽  
Functional Results ◽  
Pain Scale ◽  
Adolescents And Young Adults ◽  
Tibial Tubercle ◽  
Tibial Tubercle Osteotomy ◽  
Superficial Infection ◽  
Increased Risk ◽  
Anterior Tibial ◽  
Complete Detachment

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. 

Distalising tibial tubercle osteotomy decreases patellar tendon force — A treatment rationale for recalcitrant patellar tendinopathy

The Knee ◽  
2020 ◽  
Vol 27 (3) ◽  
pp. 871-877 ◽  
Author(s):  
Michael J. Dan ◽  
Joseph Cadman ◽  
James McMahon ◽  
William C.H. Parr ◽  
David Broe ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Patellar Tendinopathy ◽  
Tibial Tubercle ◽  
Tibial Tubercle Osteotomy ◽  
Tendon Force

Biomechanical investigation of tibial tubercle osteotomy fixed with various screw configurations

Injury ◽  
2019 ◽  
Vol 50 (2) ◽  
pp. 263-271 ◽  
Author(s):  
Chih-Wei Chang ◽  
Yen-Nien Chen ◽  
Chun-Ting Li ◽  
Chi-Rung Chung ◽  
Chung‐Chih Tseng ◽  
...  
Keyword(s):  
Tibial Tubercle ◽  
Tibial Tubercle Osteotomy ◽  
Biomechanical Investigation

Tibial Tubercle Osteotomy With Screw Fixation for Total Knee Arthroplasty

Orthopedics ◽  
2014 ◽  
Vol 37 (4) ◽  
pp. e367-e373 ◽  
Author(s):  
Nobuaki Chinzei ◽  
Kazunari Ishida ◽  
Ryosuke Kuroda ◽  
Tomoyuki Matsumoto ◽  
Seiji Kubo ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Screw Fixation ◽  
Tibial Tubercle ◽  
Tibial Tubercle Osteotomy ◽  
Total Knee

High accuracy of the osteotomy angle can be achieved without the use of calibrated guides when performing anteromedialisation tibial tubercle osteotomy

2019 ◽  
Vol 4 (3) ◽  
pp. 127-130
Author(s):  
Jakob Ackermann ◽  
Alexandre Barbieri Mestriner ◽  
Kirstin Marie Shu Small ◽  
Emily Sheehy ◽  
Andreas H Gomoll
Keyword(s):  
Intraclass Correlation ◽  
Case Series ◽  
High Accuracy ◽  
Tibial Tubercle ◽  
Tibial Tubercle Osteotomy ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Postoperative Mri ◽  
Good Exposure

ObjectivesTibial tubercle osteotomy (TTO) is a frequently performed procedure for the treatment of patellar instability and allows for chondral defect unloading when performed in conjunction with cartilage repair. Accurate intraoperative execution of the osteotomy is of utmost importance to achieve the desired outcome. The purpose of this study is to validate the intraoperative accuracy of the osteotomy angle of TTO.MethodsBetween January 2007 and May 2017, a total of 212 patients underwent TTO; however, only patients with postoperative axial (magnetic resonance) imaging were eligible for inclusion. Thus, 124 patients (126 knees) (58.5%) were evaluated in this study. The osteotomy angle was assessed by two independent reviewers (fellowship trained radiologist and orthopaedic surgeon) using MRI and compared with preoperative planning.ResultsPatients were on average 32.89 years (range 15–56, SD 9.7) of age at the time of surgery with an equal gender contribution (50% women vs 50% men). Postoperative MRI was conducted at 12.53 months (range 2–91 months, SD 12.2) follow-up. Postoperative MRI-measured osteotomy angles averaged 104.1% of planned angles and showed a high intraclass correlation coefficient of 0.87. The accuracy of the osteotomy cut did not vary with the planned steepness of the cut (p=0.984).ConclusionThis study demonstrates that the high accuracy of the osteotomy angle can be achieved without the use of calibrated guides. Good exposure and visualisation of the TT intraoperatively are paramount for the precision of anteromedialisation TT osteotomy using the Fulkerson’s technique.Level of evidenceLevel IV, retrospective case seriesIRB protocol number2017P001677

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