title: Triple positioning of tibial tubercle osteotomy for patellofemoral disorders.
abstract: OBJECTIVE
  Patellofemoral disorders are often associated with patellofemoral malalignment. Tibial tubercle transfer is an effective method to correct the patellofemoral malalignment. This study evaluated the long-term results of triple positioning of tibial tubercle osteotomy for refractory patellofemoral disorders with 10-year follow-up.
  
  
  METHODS
  Fifty-six patients with 62 knees underwent triple positioning of tibial tubercle osteotomy for refractory patellofemoral disorders. All patients received standard rehabilitation protocol postoperatively. The average length of follow-up was 128.5±9.8 months (range 116 to 149). The evaluations included pain score, Kujala patellofemoral score, Lysholm score and radiograph of the knee.
  
  
  RESULTS
  The overall clinical results were excellent in 41.9%, good in 37%, fair in 12.9% and poor in 5% at 1 year; and 29% excellent, 41% good, 18.3% fair and 9.3% poor at 10 years. Satisfactory results were 78.9% and 70.9%, and unsatisfactory results 21.1% and 29.1% at 1 year and 10 years respectively. There was no correlation of clinical outcomes with age, sex, body weight and height and preoperative pain score. However, there was a positive correlation of clinical outcomes with the improvement of the congruence angle on postoperative X-rays of the knee, and a negative correlation of clinical outcome with the severity of articular cartilage damage assessed in arthroscopy. The complications included 1 non-union and 1 infection with non-union.
  
  
  CONCLUSIONS
  Triple positioning of tibial tubercle osteotomy is effective and long lasting in patients with patellofemoral disorders with 70.9% satisfactory results at 10-year follow-up.
  
  
  METHODS
  IV (refer to instructions for detailed description on the level of evidence).
authors.affiliation: Department of Orthopedic Surgery, Section of Sports Medicine, Chang Gung University College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan. Electronic address: w281211@adm.cgmh.org.tw.
authors.forename: Ching-Jen
authors.initials: CJ
authors.lastname: Wang
authors.affiliation: Department of Orthopedic Surgery, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan.
authors.forename: To
authors.initials: T
authors.lastname: Wong
authors.affiliation: Department of Orthopedic Surgery, Section of Sports Medicine, Chang Gung University College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan.
authors.forename: Jih-Yang
authors.initials: JY
authors.lastname: Ko
authors.affiliation: Department of Orthopedic Surgery, Section of Sports Medicine, Chang Gung University College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan.
authors.forename: Ka-Kit
authors.initials: KK
authors.lastname: Siu
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001182:Arthroscopy; D017760:Bone Malalignment / Q000209:etiology / Q000601:surgery*; D002358:Cartilage, Articular / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D010329:Patella / Q000000981:diagnostic imaging; D057071:Patellofemoral Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D017060:Patient Satisfaction; D011859:Radiography; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*; D064232:Visual Analog Scale; D055815:Young Adult