Tibial Tuberosity

A tibial tuberosity transfer or osteotomy is a form of patellar realignment operation that can help prevent the kneecap dislocating or reposition an arthritic kneecap into a healthier less painful position. It works by changing the angle at which the patellar tendon pulls on the kneecap, which can make it more stable or less painful.

Why is it Performed?

The tibial tuberosity is a bump on the front of the shin bone. It is the point to which the patellar tendon is attached. If the knee is affected by conditions such as instability or osteoarthritis, the kneecap can be shifted out of alignment and may become unstable or simply become more and more painful. Tibial tuberosity surgery may be able to correct this problem by altering the alignment. Tibial tuberosity surgery may be recommended if other options such as physiotherapy haven’t helped, and the knee remains unstable or painful. In some cases, the procedure may be combined with other treatments such as MPFL reconstruction to repair any other damage to the knee. A specialist can assess the knee joint in order to determine which treatments are right for you.

The Procedure

Tibial tubercle transfer or osteotomy is usually performed under a general anaesthetic. The knee will sometimes be examined arthroscopically before the osteotomy or bone transfer procedure is performed though an incision at the front of the knee. The surgeon will mobilise the part of the bone where the patellar tendon is attached to the shin or tibia. The section of bone will be moved inwards, towards the centre of the knee and then reattached in a slightly different position. The bone will be secured using screws. Moving the attachment point of the patellar tendon will shift the angle along which the tendon pulls on the kneecap. It should reduce the risk of the kneecap dislocating and reduce the strain on the painful parts of the knee. The surgeon will check that the correct angle has been achieved before closing up the surgical incision.

Recovering fully from tibial tuberosity surgery will take 3-4 months. You will experience some pain, swelling and stiffness at first. You will usually need to use crutches and wear a knee brace for about Eight weeks. Physiotherapy is an important part of recovery as it will help you to improve your strength and mobility after the operation. It should take between three and six months for your knee to recover fully.

Risks and Benefits

• All surgery carries a small risk of complications such as infection, blood clots, and allergic reactions to the anaesthetic. Other potential issues following tibialtubercule osteotomy include compartment syndrome and slow healing of the bone.
• The surgery should help to relieve symptoms such as pain and mobility problems.
• Having the procedure should help to stabilise the knee and prevent further problems, such as recurring dislocation of the kneecap.

If you would like to learn more about patellar stabilisation surgery and whether it is right for you, make an appointment at the Cumbrian Knee Clinic to talk to an experienced specialist.