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
- 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