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Tibial Tubercle Osteotomy

Tibial tubercle osteotomies are important surgical techniques in the operative management of patellar instability and patellofemoral pain.

When is a patient a candidate for tibial tubercle osteotomy?

  • History of multiple knee subluxations or dislocations
  • History of patellar and femoral pain
  • Physical Therapy has been exhausted
  • Non surgical management has failed

What is involved pre operatively?

  • continuation of therapy to help strengthening the quadriceps
  • x-rays
  • MRI
  • Pre operative anesthesia consult depending on patients needs

What is involved with the surgery?

  • The surgical approach is relatively straight forward and the osteotomy is a low risk technique
  • The osteotomy technique is a greenstick-style distal osteotomy that avoids periosteal stripping appears to optimize bony consolidation, thereby minimizing postoperative fractures.

What does post operative incision care consist of?

  • Day 3 patient may remove ace wrap and dressing
  • Steri strips are to remain intact until shriveling up or falling off
  • Patient may shower after day 3
  • Patient may not bath or swim until released by the doctor

Post operative care?

  • Patient will be NON weight bearing on the affected leg for 6 weeks
  • Patient will require use of crutches
  • Patient will wear a knee immobilizer
  • Patient will start slow Range of Motion Exercises at home

When is the Follow up Visits?

  • 7-10 days post operatively
  • 6 weeks post operatively
  • 3 months postoperatively
  • As needed

When can the patient start to bear weight?

  • Generally 6 weeks postoperatively
  • Then the patient can bear weight without crutches in the knee immobilizer for about a week then wean out of the knee immobilizer.

When can the patient return to full activity?

This is individualized for each patient, but generally 3 months after surgery.  Some patients may require the use of a patellar stabilizing brace for contact sports.

When to call the office?

  • fever greater than 101
  • increased pain not tolerated by pain medication
  • redness or drainage at the incision site