A Modified Osteotomy for Anteromedialization of the Tibial Tubercle

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Presentation transcript:

A Modified Osteotomy for Anteromedialization of the Tibial Tubercle Michael G. Saper, D.O., Benjamin A. Cox, D.O., David A. Shneider, M.D. Arthroscopy Techniques Volume 6, Issue 4, Pages e1107-e1112 (August 2017) DOI: 10.1016/j.eats.2017.03.028 Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 1 Intraoperative photograph of a left knee secured in a leg holder after a midline skin incision. Electrocautery is used to free the lateral side of the patellar tendon. The lateral retinaculum is carefully opened at the inferior lateral tip of the patella and carried only far enough proximally to allow the patella to center in the trochlear groove. Arthroscopy Techniques 2017 6, e1107-e1112DOI: (10.1016/j.eats.2017.03.028) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 2 Intraoperative photograph sequence of a left knee undergoing anteromedialization of the tibial tubercle. (A) The boundaries of the tibial tubercle are identified and marked. Aiming parallel to the posterior tibial slope of the proximal tibia, the near cortex is drilled with a 4.5-mm drill. (B) The osteotomy is performed using an oscillating saw. (C) An osteotome is used to lever the tubercle fragment into the desired position. (D) The tibial tubercle is secured with two 4.5-mm cortical screws. Arthroscopy Techniques 2017 6, e1107-e1112DOI: (10.1016/j.eats.2017.03.028) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 3 Intraoperative photograph of a left knee after fixation of the tibial tubercle. Rotating a flap of the adjacent iliotibial band to close the defect repairs the lateral release. Arthroscopy Techniques 2017 6, e1107-e1112DOI: (10.1016/j.eats.2017.03.028) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 4 Intraoperative photograph of a left knee after lateral release, anteromedial tibial tubercle transfer, and repair of the lateral retinaculum. Arthroscopy Techniques 2017 6, e1107-e1112DOI: (10.1016/j.eats.2017.03.028) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions