Tibial tuberosity transfer for episodic patellar dislocation.
Numerous surgical techniques have been described to address episodic patellar dislocations. Some of them involve the soft tissues whereas others primarily address a bony correction. Four principal anatomic factors have been identified that increase the risk for episodic patellar dislocations: trochlear dysplasia, patella alta, patellar tilt, and an excessive tibial tubercle-trochlear groove distance. A treatment algorithm has been proposed to correct each of these factors. It includes the tibial tuberosity transfer, which is able to correct both a patella alta and an excessive tibial tubercle-trochlear groove distance. The tibial tuberosity can be transferred distally or medially or more frequently a combination of both. It will realign the extensor mechanism and increase patellofemoral stability. This procedure may be associated with a medial patellofemoral ligament reconstruction in case of excessive patellar tilt or rarely with a trochleoplasty for major abnormal patellar maltracking.
Servien
Elvire
E
Department of Orthopaedic Surgery, Centre Livet, Centre Hospital Universitaire, Lyon, France. elvire.servien@chu-lyon.fr
Verdonk
Peter C
PC
Neyret
Philippe
P
D001696:Biomechanical Phenomena; D006801:Humans; D010027:Osteotomy / Q000379:methods*; D031222:Patellar Dislocation / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D013977:Tibia / Q000601:surgery*