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Published in: European Journal of Orthopaedic Surgery & Traumatology 1/2020

01-01-2020 | Arthroscopy | Original Article • KNEE - ARTHROPLASTY

Plate and screw fixation of arthroscopically assisted tibial tuberosity osteotomy: technique and results

Authors: Jarrad M. Stevens, Simon B. Barton, Matthew Alexander, Jonathan D. Eldridge, Damian Clark

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 1/2020

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Abstract

Introduction

We describe a fixation technique for tibial tuberosity osteotomies (TTO) utilising a plate and screw construct which adheres to established principles of bone healing. We record and discuss the complication profile and benefits of this technique.

Method

The technique is outlined, and thirty consecutive case of TTO fixed with this combination of plate and screws were analysed during a study period from January 2018 to October 2018. All patients were followed up clinically to 3 months post-operation for the purpose of identifying early complications of surgery. Radiographic series were reviewed at 2, 6 and 12 weeks post-operation for evidence of fracture, loss of position, hardware failure and union.

Results

All cases went on to clinical and radiographic union by 12 weeks. We identified one case of hardware failure, one case of superficial infection and one case of stiffness requiring manipulation.

Conclusion

We have found this technique of plate and screw construct to be effective in arthroscopically assisted TTO fixation leading to consistent union without loss of position with a low complication profile.
Literature
1.
go back to reference Hauser EDW (1938) Total tendon transplant for slipping patella: new operation for recurrent dislocation of the patella. Surg Gynecol Obstet 66:199–214 Hauser EDW (1938) Total tendon transplant for slipping patella: new operation for recurrent dislocation of the patella. Surg Gynecol Obstet 66:199–214
2.
go back to reference Stetson WB, Friedman MJ, Fulkerson JP, Cheng M, Buuck D (1997) Fracture of the proximal tibia with immediate weightbearing after a Fulkerson osteotomy. Am J Sports Med 25:570–574CrossRef Stetson WB, Friedman MJ, Fulkerson JP, Cheng M, Buuck D (1997) Fracture of the proximal tibia with immediate weightbearing after a Fulkerson osteotomy. Am J Sports Med 25:570–574CrossRef
3.
go back to reference Fulkerson JP (1999) Fracture of the proximal tibia after Fulkerson anteromedial tibial tubercle transfer: a report of four cases. Am J Sports Med 27:265CrossRef Fulkerson JP (1999) Fracture of the proximal tibia after Fulkerson anteromedial tibial tubercle transfer: a report of four cases. Am J Sports Med 27:265CrossRef
4.
go back to reference Bellemans J, Cauwenberghs F, Brys P, Victor J, Fabry G (1998) Fracture of the proximal tibia after Fulkerson anteromedial tibial tubercle transfer: a report of four cases. Am J Sports Med 26:300–302CrossRef Bellemans J, Cauwenberghs F, Brys P, Victor J, Fabry G (1998) Fracture of the proximal tibia after Fulkerson anteromedial tibial tubercle transfer: a report of four cases. Am J Sports Med 26:300–302CrossRef
5.
go back to reference Wolff AM, Hungerford DS, Krackow KA, Jacobs MA (1989) Osteotomy of the tibial tubercle during total knee replacement: a report of twenty-six cases. J Bone Joint Surg 71A:848–852CrossRef Wolff AM, Hungerford DS, Krackow KA, Jacobs MA (1989) Osteotomy of the tibial tubercle during total knee replacement: a report of twenty-six cases. J Bone Joint Surg 71A:848–852CrossRef
6.
go back to reference Cosgarea AJ, Freedman JA, McFarland EG (2001) Nonunion of the tibial tubercle shingle following Fulkerson osteotomy. Am J Knee Surg 14:51–54PubMed Cosgarea AJ, Freedman JA, McFarland EG (2001) Nonunion of the tibial tubercle shingle following Fulkerson osteotomy. Am J Knee Surg 14:51–54PubMed
7.
go back to reference Ritter MA, Carr K, Keating EM, Faris PM, Meding JB (1996) Tibial shaft fracture following tibial tubercle osteotomy. J Arthroplasty 11:117–119CrossRef Ritter MA, Carr K, Keating EM, Faris PM, Meding JB (1996) Tibial shaft fracture following tibial tubercle osteotomy. J Arthroplasty 11:117–119CrossRef
8.
go back to reference Fulkerson JP (1983) Anteromedialization of the tibial tuberosity for patellofemoral malalignment. Clin Orthop Relat Res 177:176–181 Fulkerson JP (1983) Anteromedialization of the tibial tuberosity for patellofemoral malalignment. Clin Orthop Relat Res 177:176–181
9.
go back to reference Pemmaraju G, Raad A, Kotecha A, Chugh S, Mughal E (2015) Modified technique of tibial tuberosity transfer. Arthrosc Tech 4(4):349–352CrossRef Pemmaraju G, Raad A, Kotecha A, Chugh S, Mughal E (2015) Modified technique of tibial tuberosity transfer. Arthrosc Tech 4(4):349–352CrossRef
10.
go back to reference Clark D, Walmsley K, Schranz P, Mandalia V (2017) Tibial tuberosity transfer in combination with medial patellofemoral ligament reconstruction: surgical technique. Arthrosc Tech 6(3):591–597CrossRef Clark D, Walmsley K, Schranz P, Mandalia V (2017) Tibial tuberosity transfer in combination with medial patellofemoral ligament reconstruction: surgical technique. Arthrosc Tech 6(3):591–597CrossRef
11.
go back to reference Whiteside LA, Ohl MD (1990) Tibial tubercle osteotomy for exposure of the difficult total knee arthroplasty. Clin Orthop Relat Res 260:6–9CrossRef Whiteside LA, Ohl MD (1990) Tibial tubercle osteotomy for exposure of the difficult total knee arthroplasty. Clin Orthop Relat Res 260:6–9CrossRef
12.
go back to reference Mendes MW, Caldwell PE, Jiranek JA (2004) The results of tibial tubercle osteotomy for revision total knee arthroplasty. J Arthroplasty 19:167–174CrossRef Mendes MW, Caldwell PE, Jiranek JA (2004) The results of tibial tubercle osteotomy for revision total knee arthroplasty. J Arthroplasty 19:167–174CrossRef
13.
go back to reference Warner BT, Kamath GV, Spang JT, Weinhold PS, Creighton RA (2013) Comparison of fixation methods after anteromedialization osteotomy of the tibial tubercle for patellar instability. Arthroscopy 29:1628–1634CrossRef Warner BT, Kamath GV, Spang JT, Weinhold PS, Creighton RA (2013) Comparison of fixation methods after anteromedialization osteotomy of the tibial tubercle for patellar instability. Arthroscopy 29:1628–1634CrossRef
15.
go back to reference Davis K, Caldwell PE, Wayne J, Jiranek WA (2000) Mechanical comparison of fixation techniques for the tibial tubercle osteotomy. Clin Orthop 380:241–249CrossRef Davis K, Caldwell PE, Wayne J, Jiranek WA (2000) Mechanical comparison of fixation techniques for the tibial tubercle osteotomy. Clin Orthop 380:241–249CrossRef
Metadata
Title
Plate and screw fixation of arthroscopically assisted tibial tuberosity osteotomy: technique and results
Authors
Jarrad M. Stevens
Simon B. Barton
Matthew Alexander
Jonathan D. Eldridge
Damian Clark
Publication date
01-01-2020
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 1/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-019-02536-x

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