Tibial Tubercle Osteotomy
Tibial Tubercle Osteotomy is a surgical procedure which is performed along with other procedures to treat kneecap (patellar) instability, pain and osteoarthritis. Surgical treatment is indicated when physical therapy and other non-surgical methods have failed and there is history of multiple knee dislocations.
Tibial tubercle transfer technique involves realignment of the tibial tubercle (a bump in the front of the shin bone) such that the knee cap (patella) traverses in the center of the femoral groove. This removes the load off the painful portions of the knee cap and reduces the pain.
- Avoid certain medications. Your doctor may want you to avoid taking medications or dietary supplements that can increase your risk of bleeding.
- Fast beforehand. Depending on the type of anesthesia you’ll have, your doctor may want you to avoid eating, and drinking six to twelve hours before your procedure.
- Arrange for a ride. You won’t be allowed to drive yourself home after the procedure, so make sure someone will be available to pick you up. If you live alone, ask someone to check on you that evening or, ideally, stay with you the rest of the day.
- Choose loose clothing. Wear loose, comfortable clothing baggy gym shorts, slip on shoes for example, if you’re having knee surgery so you can dress easily after the procedure.
The procedure is performed under general anesthesia and you will be completely unaware of the surgery until you wake up in the recovery room. At first, knee arthroscopy will be performed to inspect the inside portions of the knee joint. It involves small incisions or portals through which small instruments are passed and a video camera is used to visualize the anatomy of the knee joint, evaluate patella cartilage and assess patella tracking.
Tibial tubercle osteotomy and transfer is done through an incision made in the front of your leg just below the patella. Several revisions to the bone and knee structure are completed.
The Osteotomy segment is then moved under direct vision into a position that assures proper tracking of the patella. The tracking pattern can be confirmed arthroscopically. The mobilized bone is then fixed into its new place using screws, which can be removed later if they cause irritation
You may have minimal to moderate knee discomfort for several days or weeks after the surgery. Oral pain medications will be prescribed that helps control your pain. Keep the operated leg elevated and apply ice bag over the area for 20 minutes. This decreases swelling as well as pain. You will have a leg brace which may be removed only while sitting with your leg elevated and when using the continuous passive motion (CPM) unit. Physical therapy exercises should be done as it helps in regaining mobility. Eat healthy food and drink plenty of water.
Risks and complications
Risks following Tibial Tubercle Osteotomy surgery are rare but may include compartment syndrome, deep vein thrombosis, infections and delayed bone healing.