Jordy van Sambeeck

Chapter 3 46 Abstract Background A tibial tubercle osteotomy (TTO) is a commonly performed procedure in young and active patients with patellofemoral complaints. Previous small patient series demonstrated a relatively high risk of complications, which appear to be technique dependent. The purpose of this large case series is to quantify the risk of procedure specific postoperative complications related to a uniform self- centering TTO technique in a large cohort, performed by two different surgeons in one center. Hypothesis We hypothesize that non-unionor fracture occurs in less than 1%of the procedures. Patients and methods Five hundred and twenty-nine knees in four hundred and forty-seven patients who underwent a self-centering TTO with at least one year of follow up were included. We performed a retrospective cohort review. Tibial fracture, osteotomy non-union, neurovascular complications, infection and wound complications that required surgical intervention were defined as major complications, miscellaneous complications were defined minor. Results The major finding in this study is the low incidence of non-union (0.6%) and tibial fracture (0.4%). In total 9 (1.7%) major complications were reported . Minor complications included superficial wound infection in five patients, two patients had a venous thrombo-embolism (VTE). Conclusion A self-centering TTO is a relatively safe technique with a low number of nonunion and fracture. Level of evidence Level IV, retrospective cohort study Key words Patella, Patellofemoral joint, Patellar instability, Patellofemoral pain, Tibial tubercle osteotomy