A safe zone for the passage of screws through the posterior tibial cortex in tibial tubercle transfer

The Knee ◽  
2005 ◽  
Vol 12 (2) ◽  
pp. 99-101 ◽  
Author(s):  
A.A. Shetty ◽  
A.J. Tindall ◽  
N. Nickolaou ◽  
K.D. James ◽  
P. Ignotus
2021 ◽  
Author(s):  
Conglei Dong ◽  
Chao Zhao ◽  
Ming Li ◽  
Huijun Kang ◽  
Kang Piao ◽  
...  

Abstract BackgroundThe objective of present study was to investigate the operative effect of patellofemoral arthroplasty combined with the tibial tubercle transfer for isolated patellofemoral arthritis patients with an increased tibial tuberosity-trochlear groove distance (>20mm). MethodsA prospective study was performed between November 2012 and December 2017. Finally, thirty-six cases, with a mean age of 61.1 ± 7.3 years, were admitted to our study. A total of 17 patients underwent patellofemoral arthroplasty combined with tibial tubercle transfer, and 19 patients underwent patellofemoral arthroplasty only. All eligible patients had CT scans preoperatively and at 12 months follow-up, to assess the stability of the patellofemoral joint on axial slices. In addition, the demographic and clinical features of all the patients were asked. Knee balance was assessed with the single leg stance test and timed get up and go, and functionality was evaluated with stair climbing test and the Western Ontario and McMaster Universities Osteoarthritis Index score. (P>0.05) ResultsPreoperatively, the data regarding the knee balance and functionality were not significantly different between the two Groups (P>0.05). Many measurements showed significant differences between the two groups at the last follow-up. Significant differences were seen in well-known measurements such as the SLST (Group I, 28.9 s (SD 7.5); Group II, 20.3 s (SD 5.9); p < 0.001), TGUG (Group I, 13.4 s (SD 3.2); Group II, 16.8 s (SD 3.1); p < 0.001), and SCT (Group I, 18.6 s (SD 6.8); Group II, 24.5 s (SD 8.7); p < 0.001). Additionally, the median WOMAC score was improved from 62.7 (SD 11.2) preoperatively to 25.7 (SD 8.2) one year postoperatively in Group I and from 64.1 (SD 10.7) to 36.2 (SD 9.7) in Group II, which were also significantly different between the groups. ConclusionsFor such special IPA patients with an increased TT-TG (>20mm), the combined operation of PFA combined with TTT can better restore the involutional relationship of patellofemoral joint and further improve the balance and function of knee joint.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Evan Drew Sheppard ◽  
Pradip Ramamurti ◽  
Seth Stake ◽  
Monica Stadecker ◽  
Md Sohel Rana ◽  
...  

2020 ◽  
Vol 49 (1) ◽  
pp. 200-206
Author(s):  
ZhiJun Zhang ◽  
Guanyang Song ◽  
Yue Li ◽  
Tong Zheng ◽  
QianKun Ni ◽  
...  

Background: Controversy exists regarding the surgical treatment of recurrent patellar dislocation (RPD) with an increased femoral anteversion angle (FAA). Medial patellofemoral ligament reconstruction (MPFL-R) either alone or combined with derotational distal femoral osteotomy (DDFO) results in favorable clinical outcomes. Purpose: To compare the clinical outcomes of MPFL-R versus MPFL-R with DDFO in treating RPD with increased FAA (>30°). Study Design: Cohort study; Level of evidence, 3. Methods: Between January 2014 and December 2017, 126 patients (135 knees) with RPD and increased FAA (>30°) were surgically treated using MPFL-R with or without DDFO and eligible for this retrospective study. These patients were allocated into 2 groups based on whether an additional DDFO was performed: the DDFO group (MPFL-R + DDFO with or without tibial tubercle transfer; n = 66) and the control group (MPFL-R with or without tibial tubercle transfer; n = 69). Pre- and postoperative patellar stability was measured using stress radiography. Patellar maltracking (J-sign) and patient-reported outcomes (Kujala, International Knee Documentation Committee, Lysholm, and Tegner scores) were evaluated and compared between the 2 groups. Subgroup analysis was performed by stratifying the results in terms of the severity of preoperative patellar maltracking (low-grade vs high-grade J-sign). Results: A total of 135 knees (126 patients) with a mean follow-up time of 3.7 ± 1.2 years were evaluated in the present study. The rates of postoperative MPFL residual graft laxity and residual J-sign were significantly lower in the DDFO group than in the control group (6% vs 19%, P = .028; 33% vs 54%, P = .018). The DDFO group had significantly higher Kujala (82.3 vs 76.7; P = .001) and Lysholm (83.7 vs 77.7; P = .034) scores than the control group had postoperatively. For patients with a preoperative high-grade J-sign, further subgroup analysis demonstrated that the DDFO group had a significantly lower rate of MPFL residual graft laxity than the control group had (18% vs 57%; P = .029). Conclusion: In this retrospective study, treatment of RPD with increased femoral anteversion using MPFL-R with DDFO yielded more favorable subjective and objective outcomes than did MPFL-R without DDFO, and this circumstance was more remarkable when the patients had a preoperative high-grade J-sign.


Author(s):  
Chris Hadley ◽  
Brandon Eck ◽  
Fotios Tjoumakaris ◽  
Matthew Pepe ◽  
Luke Austin ◽  
...  

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