A Modified Osteotomy for Anteromedialization of the Tibial Tubercle.

Tibial tubercle osteotomy is a common treatment option for a number of patellofemoral joint disorders including chondromalacia, "anterior knee pain" syndromes, patellofemoral arthritis, and patellar instability. Tibial tubercle osteotomy can modify tracking and/or patellofemoral contact forces to effect the unloading of chondral defects of the patella or trochlea, correct multiplanar suboptimal alignment, and be used in conjunction with soft-tissue stabilization procedures for instability. The purpose of this Technical Note is to describe, in detail, a modified osteotomy for anteromedialization of the tibial tubercle. The technique combines the concepts of Elmslie-Trillat and Fulkerson and modifies their techniques to produce an osteotomy that decreases lateral patellar pressure and centers the patella correctly in the trochlear groove.