Cutting of the bone to realign the kneecap.
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Tubercle Osteotomy
Tibial tubercle osteotomy is a surgical procedure in which a small portion of the tibia bone is cut to change the position of the kneecap and relieve pain caused by misalignment of the kneecap.
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Introduction
Tibial tubercle osteotomy (TTO) is a surgery to correct abnormal movement of the kneecap, also known as patellar maltracking. This condition can cause pain and instability. The surgery aims to improve alignment, relieve pain, and increase the knee's range of motion.
Anatomy and Indications
The patella (kneecap) slides in a groove on the femur (thigh bone). The tibial tubercle is a bony prominence on the tibia (shin bone) where the patellar tendon attaches. When the patella maltracks, it can cause pain and damage the cartilage. TTO is recommended for severe knee pain from patellar maltracking, instability, multiple dislocations, or early patellofemoral arthritis that has not responded to conservative treatment.
Surgical Procedure and Post-operative Care
The surgery is performed under anesthesia. An incision is made below the patella, and a cut is made in the tibia just behind the tibial tubercle. This piece of bone is then relocated to improve the patella's alignment and fixed in place with screws or wires. After surgery, a knee brace or crutches may be used for 6-8 weeks with restricted weight-bearing. Post-operative care includes keeping the leg elevated, applying ice packs, taking pain medication, and starting physical therapy to strengthen the knee muscles.
Risks and Complications
Risks include infection, blood clots, joint stiffness, persistent pain, numbness, and damage to nerves, vessels, or ligaments.