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. 2024 Oct 10;12(10):23259671241278722.
doi: 10.1177/23259671241278722. eCollection 2024 Oct.

Complications and Radiographic Outcomes of Tibial Tubercle Osteotomy at Minimum 5-Year Follow-up

Sercan Yalcin  1 , Karrington Seals  1 , Peter Joo  2 , John P Fulkerson  2 , Lutul D Farrow  1
Affiliations

Complications and Radiographic Outcomes of Tibial Tubercle Osteotomy at Minimum 5-Year Follow-up

Sercan Yalcin et al. Orthop J Sports Med. .

Abstract

Background: Tibial tubercle osteotomy (TTO) is a commonly utilized surgery in the treatment of patellofemoral instability and chondrosis. A number of case series studies have reported on the mid- and long-term outcomes with varying complication rates.

Purpose: To report the incidence of major complications after TTO and the rate of progression of knee osteoarthritis at midterm follow-up.

Study design: Case series; Level of evidence, 4.

Methods: All patients who underwent primary TTO between January 1, 2010 and December 31, 2015, and who had ≥5 years of clinical follow-up data were included. Patient demographics and clinical and radiographic outcomes were recorded. Risk factors for complications were identified using multivariate logistic regression analysis.

Results: A total of 72 patients were included. The mean follow-up period was 104.8 months (range, 67-138 months). The overall complication rate was 38.9% (28/72 patients), and the incidence of major complications was 6.9%. Univariate logistic regression analysis revealed that patients with a history of smoking were more likely to experience a complication (odds ratio = 4.33 [95% CI, 1.29-14.53]; P = .02). Multivariate analysis with TTO as the main predictor indicated that complication rates were not affected by TTO procedure (TTO vs TTO+other), number of screws, or distalization. There was also no difference between anteromedialization and medialization TTO techniques. The rate of patients with Kellgren-Lawrence grade 3 to 4 increased from 12.0% preoperatively to 23.9% at the final follow-up. New osteophyte formation was detected in 5.8% of patients on anteroposterior radiographs and in 9.1% of patients on lateral radiographs.

Conclusion: In the current study, TTO was found to have a major complication rate of 6.9% at midterm follow-up. Smoking was a risk factor for major complications. Only 11.9% of patients had progression in tibiofemoral osteoarthritis at midterm follow-up.

Keywords: TTO; complication; joint preservation; patellar instability; tibial tubercle osteotomy.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: J.P.F. has received grant support from Encore Medical and consulting fees from Linvatec. L.D.F. has received hospitality payments from DJO. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

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