Tibial Tubercle Osteotomy

What is a Tibial Tubercle?

Also called the tibial tuberosity, the tibial tubercle is part of the lower knee bone that makes up the knee joint. This large, long “bump” on the front of your knee is where the patellar tendon attaches the patella (kneecap) to the shin bone. The tibial tuberosity forms the end-part of the knee joint that acts as a lever to extend the knee and prevents it from collapsing when the foot comes down on the ground.

What is a Tibial Tubercle Osteotomy (TTO)?

A tibial tubercle osteotomy (TTO) is an orthopedic surgical procedure that treats patella (kneecap) maltracking. The goal of TTO is to improve the alignment of the patella in relation to the femur (thigh bone). This specialized surgery involves moving the tibial tubercle and the attached patellar tendon to a different location. If the patella is high riding (a condition called patella alta) the structure will be moved further down the tibia. It can also be moved medially to treat certain cartilage/arthritic conditions and patella instability. Surgeries of this nature are very specialized and require the extensive experience of Dr. Armando Vidal, orthopedic knee surgeon serving patients in Vail, Aspen and the surrounding Denver, Colorado communities.

When is a TTO recommended?

Patients who suffer from patellar maltracking often have chronic anterior knee pain and/or instability. This pain can worsen with daily activities such as going up and down stairs or sitting for prolonged periods of time. Patients who have kneecap instability or arthritis on the outside of the knee, known as patellofemoral compartment arthritis, may be candidates for this type of surgical treatment. Tibial tubercle osteotomy can help decrease knee pain, realign the patella and prolong or delay arthritis and the subsequent need for a total knee replacement.

Am I a candidate for a Tibial Tubercle Osteotomy?

The diagnosis and medical workup for this procedure can be extensive. Dr. Vidal will request a long leg alignment x-ray to see if there are alignment issues, especially the presence of valgus (knock kneed) along with regular x-rays to ensure that there is not a significant amount of arthritis. An MRI is done to determine the shape of the trochlea and a CT scan will determine the distance of the patient’s tibial tubercle to throchlear groove (TT-TG).

Can a TTO be done with an MPFL reconstruction?

Often tibial tubercle osteotomies can be done in conjunction with medial patellofemoral ligament reconstruction, or cartilage repair surgery. Dr. Vidal has found that a TTO can reduce the forces on the patella, while a MPFL reconstruction helps stabilize the knee joint. The end result is decreased symptoms of pain and, with proper joint alignment, the reduced risk of arthritis.

What is the recovery time following a tibial tubercle osteotomy?

For patients in Vail, Aspen and the surrounding Denver Colorado communities, Dr. Vidal suggests 6 weeks on non-weightbearing to ensure the tibial tubercle heals properly. After x-rays are obtained at the 6-week mark, Dr. Vidal will consult with the patient about advancing their activities to include weight bearing. Healing time for this procedure can vary greatly and it’s important to follow Dr. Vidal and his team’s instructions for a successful recovery.

Complex Knee Surgeon

If you are experiencing patellar maltracking and chronic anterior knee pain and/or instability, you may be a candidate for a tibial tubercle osteotomy. This procedure helps to realign the knee to improve movement between the bones of the knee joint. Complex knee surgeon, Doctor Armando Vidal provides has much experience performing this specialized procedure for patients in Vail, Aspen, and the surrounding Denver, Colorado communities. Contact Dr. Vidal’s team today!