title: Tibial tubercle osteotomy for access during revision knee arthroplasty: Ethibond suture repair technique.
abstract: BACKGROUND
  Tibial Tubercle Osteotomy has shown much promise in revision total knee replacement. Methods of repair previously described include screw and wire fixation. Both methods have significant complications.
  
  
  METHODS
  This article describes suture fixation of the osteotomy using Ethibond sutures placed medially with a lateral periosteal hinge.
  
  
  RESULTS
  This method of fixation relies upon an adequate osteotomy segment including the entire insertion of the patella tendon. The lateral periosteal hinge is maintained and adds to the stability of the construct. A minimum of two number 5 Ethibond sutures are passed medially through drill holes to secure the osteotomy segment. No post-operative immobilisation is required.
  
  
  CONCLUSIONS
  Ethibond sutures provide adequate fixation of the tibial tubercle osteotomy segment in revision knee arthroplasty with reduced risk of complication as compared to conventional fixation methods.
authors.affiliation: Department of Trauma and Orthopaedics, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK. crdeane@gmail.com
authors.forename: Crawford R
authors.initials: CR
authors.lastname: Deane
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Ferran
authors.forename: Adel
authors.initials: A
authors.lastname: Ghandour
authors.forename: Rhidian L
authors.initials: RL
authors.lastname: Morgan-Jones
mesh_terms: D020341:Absorbable Implants; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D004548:Elasticity; D006801:Humans; D019563:Mechanics; D009984:Orthopedic Fixation Devices; D010027:Osteotomy / Q000379:methods*; D011093:Polyethylene Terephthalates; D011859:Radiography; D012086:Reoperation; D013536:Suture Techniques; D013537:Sutures; D013718:Tensile Strength; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: C014534:Ethibond; D011093:Polyethylene Terephthalates