ArticleSICOT-J2023
Tibial tubercule osteotomy during the revision of total knee arthroplasty: The technique of a referral center with 10 years of experience.
Article in SICOT-J, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 5 citations in OpenAlex.
- Single-stage total knee arthroplasty revision with extensor mechanism allograft: surgical technique.SICOT-J · 2026Article
- Semi-constrained and constrained knee arthroplasty for distal femur nonunion & mal-union.Journal of clinical orthopaedics and trauma · 2025Article
- Extended Tibial Tuberosity Osteotomy: A Practical Tool for Implant Removal in Difficult Knee Revision Arthroplasties in Patients with Hemophilia.Medicina (Kaunas, Lithuania) · 2025Article
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5 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionThe Tibial Tubercle Osteotomy (TTO) technique, by lifting the distal bony attachment of the extensor mechanism, allows efficient knee exposure while preserving soft tissues and tendinous attachments. The surgical technique seems essential to obtain satisfying outcomes with a low rate of specific complications. Several tip sand tricks can be used to improve this procedure during the revision of total knee arthroplasty (RTKA). TECHNIQUE: The osteotomy should be at least: 60 mm in length and 20 mm in width to allow fixation with 2 screws; and 10-15 mm thick to resist to screw compression. The proximal cut of the osteotomy must keep a proximal buttress spur of 10 mm to get primary stability and avoid the tubercle ascension. A smooth end of the TTO distally reduces the risk of a tibial shaft fracture. The strongest fixation is obtained using two bicortical 4.5 mm screws slightly ascendant.
resultsFrom January 2010 to September 2020, 135 patients received an RTKA with concomitant TTO and a mean follow-up of 51 ± 26 months [24-121]. The osteotomy was healed in 95% of patients (n = 128) with a mean delay of 3.4 ± 2.7 months [1.5-24]. However, there are some specific and significant complications related to the TTO. Twenty complications (15%) related to the TTO were recorded, with 8 (6%) requiring surgery.
conclusionTibial tubercle osteotomy in RTKA is an efficient procedure to improve knee exposure. To avoid tibial tubercle fracture or non-union, a rigorous surgical technique is primordial with a sufficient length and thickness of the tibial tubercle, a smooth end, a proximal step, a final good bone contact, and a strong fixation.
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