Tibial Tubercle Osteotomy

🦵 What Is a Tibial Tubercle Osteotomy?

A Tibial Tubercle Osteotomy (TTO) is a surgical procedure used to realign the kneecap (patella) to help it track properly during movement. It’s often done in people who have:

• Repeated kneecap dislocations

• Patellar instability

• Kneecap pain caused by poor alignment (patellofemoral pain syndrome)

The tibial tubercle is the bony bump on the front of your shinbone (tibia) where the patellar tendon attaches. In TTO, the surgeon cuts this piece of bone and shifts it slightly — usually inward, downward, or both — to improve how the kneecap moves.

🔧 Why Is It Done?

This procedure aims to:

• Reduce stress on the kneecap

• Improve alignment and stability

• Prevent further dislocations or damage to the joint

• Relieve chronic anterior knee pain

It’s often done together with MPFL reconstruction, especially in patients with structural issues contributing to instability.

🛠️ How Is It Performed?

• A 6 cm section of bone where the patellar tendon attaches is cut and moved.

• It’s then fixed in the new position using screws or a plate and screws.

• This changes the pull of the tendon to improve kneecap tracking.

🕒 Recovery

• Weight-bearing is limited for the first few weeks — crutches and a brace are usually needed.

• Physiotherapy is essential to regain strength and movement.

• Most patients return to normal daily activities in 2–3 months.

• Full return to sports may take 4–6 months, depending on healing and rehab progress.

⚠️ Risks and Considerations

• Risks include but are not limited to infection, blood clots, delayed bone healing, fracture, or irritation from the screws (which may later be removed).

• Not suitable for every patient — careful assessment of your knee and imaging is required.