Tibial Tubercle Osteotomy
What is a Tibial Tubercle Osteotomy?
When an individual has patellofemoral instability or patellar maltracking, they may require a Tibial Tubercle Osteotomy. A Tibial Tubercle Osteotomy works by changing the insertion point of the patellar tendon on the tibia. Surgeons also utilize tibial tubercle osteotomy during total knee replacement as well as knee replacement revisions.
What are the symptoms when a Tibial Tubercle Osteotomy is needed?
Patients who may benefit from a Tibial Tubercle Osteotomy often report feelings of instability and anterior knee pain. The pain in the front of the knee may feel chronic or come and go. The pain of a Tibial Tubercle Osteotomy candidate typically worsens with stairs, sitting for prolonged periods of time, and recreational activities.
If a patient shows signs of osteoarthritis between the patella and femur, a surgeon cannot perform a Tibial Tubercle Osteotomy. If a patient exhibits symptoms of osteoarthritis, a surgeon can perform a Medial Patellofemoral Ligament Reconstruction or cartilage repair. These surgeries work by taking pressure off the patella and in turn reducing the pain and symptoms.
How does a Tibial Tubercle Osteotomy work?
A Tibial Tubercle Osteotomy works by correcting the malalignment of the patella in the trochlear groove. The knee surgeon moves some of the bone and properly aligns the patella which reimplements the stability of the knee, therefore eliminating symptoms. With stability issues caught early, the probability of arthritis or further issues decreases.
Surgeons perform Tibial Tubercle Osteotomy’s arthroscopically. An arthroscopic surgery means that the surgery is performed inserting tools into small portals. One portal has a camera inserted so the surgeon can see the inside of the surgical area while performing the surgery through the remaining portals. The amount of portals varies depending on the surgery. The benefits of arthroscopic surgery compared to open surgery include smaller incisions, lower infection rates, and faster healing times. At this point in the surgery, the surgeon determines any cartilage damage and addresses it as he/she sees fit.
Once any cartilage damage is addressed and treated, the surgeon makes a 3-5 inch incision on the front aspect of the knee. The surgeon then takes a 2 inch portion of the tibial tubercle and repositions it to allow ample room for the patellar tendon. Held together by two screws, the tibial tubercle heals in its new position.
What is the recovery from a Tibial Tubercle Osteotomy?
Following surgery, the patient typically stays in the hospital for one to two days. The patient wears a brace, utilizes crutches for 6 weeks, and takes part in a physical therapy and potentially an occupational therapy program prescribed by the surgeon.
If you think you may need a tibial tubercle osteotomy, call 817-375-5200 to schedule an appointment with an orthopedic specialist!