Reducing the tibial tuberosity-trochlear groove distance in patella stabilization procedure. too much of a (good) thing [editorial]? Editorial Article uri icon
Overview
abstract
  • A recent study suggests that aggressive correction of the tibial tuberosity-trochlear groove (TT-TG) distance by tibial tubercle osteotomy and medialization during patellar stabilization surgery can result in diminished outcomes. The mechanism may be overmedialization resulting in excessive medial patellofemoral and tibial-femoral pressure. Measurement of TT-TG may be inaccurate, and medialization of the tibial tubercle may not be required in cases of lateral patellar instability with TT-TG >20 mm (which is a current algorithm). My indication for tibial tubercle osteotomy, generally anteromedialization, is lateral patellofemoral chondrosis, and my goal is to create an intraoperative tubercle-sulcus angle of 0, which can be readily visualized with the knee at 90°. This is true regardless of the preoperative TT-TG measurement, and this intraoperative measurement mitigates against an excessive tubercle-sulcus angle of 0, which can be readily visualized with the knee at 90° and is true regardless of the preoperative TT-TG medialization.

  • Link to Article
    publication date
  • 2018
  • published in
  • Arthroscopy  Journal
  • Research
    keywords
  • Knee
  • Surgery
  • Additional Document Info
    volume
  • 34
  • issue
  • 8