Modified Technique of Tibial Tuberosity Transfer

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Presentation transcript:

Modified Technique of Tibial Tuberosity Transfer Gopalakrishna Pemmaraju, F.R.C.S.(Tr&Orth), Abbas Raad, M.R.C.S., Amit Kotecha, M.B.B.S., M.R.C.S., Sanjiv Chugh, F.R.C.S.(Tr&Orth), Ejaz Mughal, F.R.C.S.(Tr&Orth) Arthroscopy Techniques Volume 4, Issue 4, Pages e349-e352 (August 2015) DOI: 10.1016/j.eats.2015.03.009 Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 1 A left knee, side view, after preparation and positioning in approximately 45° of flexion. Arthroscopy Techniques 2015 4, e349-e352DOI: (10.1016/j.eats.2015.03.009) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 2 A vertical skin incision is made either just medial to the tuberosity prominence (for a combined medial patellofemoral ligament and tibial tuberosity transfer) or lateral to the tuberosity prominence (for isolated tibial tuberosity transfer). Arthroscopy Techniques 2015 4, e349-e352DOI: (10.1016/j.eats.2015.03.009) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 3 The line of osteotomy is marked, starting at the inferolateral border of the patella and extending distally, just anterior to the anterolateral-compartment muscles, with a blade. Arthroscopy Techniques 2015 4, e349-e352DOI: (10.1016/j.eats.2015.03.009) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 4 With the foot internally rotated, osteotomy is performed using an oscillating saw, and at the distal end, the saw blade is angled upward to exit the anterior cortex. Arthroscopy Techniques 2015 4, e349-e352DOI: (10.1016/j.eats.2015.03.009) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 5 The surgeon uses an osteotome to elevate the tuberosity fragment, gently maintaining the soft-tissue attachments distally. Arthroscopy Techniques 2015 4, e349-e352DOI: (10.1016/j.eats.2015.03.009) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 6 The tuberosity fragment is medialized and held in position by two 4-mm cannulated screw guidewires placed in a parallel manner. Arthroscopy Techniques 2015 4, e349-e352DOI: (10.1016/j.eats.2015.03.009) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions