What to expect after a tibial tubercle osteotomy? A 10-year retrospective study of clinical and radiologic outcomes

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Sports Medicine

Background:

• Patellofemoral instability (PFI) is complex, involving bone and soft tissue issues.
• Tibial tubercle osteotomy (TTO) corrects alignment but has high recurrence rates (50%) when TT-TG >20mm.
• Existing long-term data on TTO outcomes for PFI is limited, necessitating further research.

Purpose of the Study:

• To evaluate the 10-year clinical and radiological outcomes of Tibial Tubercle Osteotomy (TTO) for Patellofemoral Instability (PFI).
• To identify predictors of suboptimal results following TTO in patients with PFI.
• To assess the long-term efficacy and complications of TTO in managing PFI.

Main Methods:

• Retrospective observational study of 36 knees undergoing TTO for PFI.
• Collected demographic, clinical, and surgical data, including pre- and post-operative imaging (CT/MRI).
• Assessed radiological parameters (TT-TG, patellar tilt/displacement) and functional scores (Kujala, Lysholm).

Main Results:

• TTO significantly improved TT-TG distance, patellar tilt, and displacement.
• Recurrent dislocations occurred in 14% of cases, mainly in younger females with residual malalignment.
• Despite 54.8% having advanced chondropathy, no correlation was found with age, alignment, or functional scores.

Conclusions:

• Tibial tubercle osteotomy (TTO) demonstrates reliable long-term effectiveness for treating patellofemoral instability.
• The risk of joint degeneration post-TTO is considerable, especially in patients with malalignment or advanced age.
• Individualized surgical planning is crucial for optimizing TTO outcomes in PFI management.