Jordy van Sambeeck

Chapter 4 58 Abstract Introduction In patients with recurrent patellar dislocations, a tibial tubercle osteotomy (TTO) can be indicated to correct patella alta or an increased trochlear groove - tibial tubercle distance. Several surgical techniques are described. Previous studies emphasize that detaching osteotomies results in devascularisation, which can lead to non-union and tibial shaft fractures. The aim of this study was to report complication rates directly related to the surgical technique of a V-shaped TTO, where the tubercle is completely released from its periosteum using a step-cut osteotomy. Methods The retrospective case series comprised 263 knees in 203 patients who underwent a V-shaped TTO, with or without additional realignment procedures between March 2004 and October 2017. Data was obtained from available patient files. Complications were defined as minor or major. Results Thirteen major complications were registered (4.9%) including 2 tibial fractures (0,75%) and 1 non-union (0.37%). Five complications (1.9%) were defined as minor. Removal of the screws because of irritation or pain was seen in 22 cases (8.2%). Conclusion A V-shaped TTO is a safe procedure in comparison to other surgical techniques. The presumed higher risk for tibial fractures or pseudo-arthrosis could not be confirmed. Key terms MPFL, patellafemoral instability, tibial tubercle, TTO