Tibial tubercle osteotomy yielded good outcomes for patellofemoral malalignment, damage


Disclosures: Rosso reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

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According to the published results, tibial tubercle osteotomy for patients with patellofemoral malalignment and chondral disease without instability resulted in positive clinical outcomes and acceptable complication and failure rates.

In December of 2020, Federica Rosso, MD, and colleagues systematically reviewed 18 studies which included 851 patients who underwent 892 tibial tubercle osteotomies (TTOs) with an average follow-up of 49.1 months. Researchers noted indications for TTO were “poorly described” throughout the literature; however, chronic anterior knee pain was a main indication in all studies.

An anteriorization technique was performed in six studies (312 cases); a medialization technique was performed in two studies (41 cases); and an anteromedialization technique was performed in 10 studies (539 cases). TTO was associated with lateral release in 247 cases ( 27.7%), as noted in seven studies. Despite differing outcome scoring systems, TTO yielded “significant improvements” across the literature, the researchers noted. The average rate of good to excellent results was 78.7%, with a complication rate of 9.9% ( reported across 15 studies) and a failure rate of 6.2% (reported across four studies).

While no consensus was reached regarding indications for TTO to treat patellofemoral (PF) chondral disease throughout the literature, Rosso and colleagues concluded TTO yielded positive outcomes in this population.

“TTO to treat PF chondral disease seems to provide good clinical outcomes and acceptable complication/failure rates,” they wrote in the study. “High-quality studies with homogeneous methods are required to precisely determine ideal candidates for TTO, most reliable surgical techniques and outcomes,” they added.

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