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. 2024 Jun 13;4(3):26350254241227439.
doi: 10.1177/26350254241227439. eCollection 2024 May-Jun.

Tibial Tubercle Anteromedialization Using the Multi-Directional Tibial Tubercle Transfer System

Anna Bartsch  1   2   3 , Ran Atzmon  1 , Kinsley Pierre  1 , Monica S Vel  1 , Seth L Sherman  1
Affiliations

Tibial Tubercle Anteromedialization Using the Multi-Directional Tibial Tubercle Transfer System

Anna Bartsch et al. Video J Sports Med. .

Abstract

Background: Tibial tubercle osteotomy (TTO) can realign the patellofemoral joint and reduce patellofemoral contact stress. Anteriorization can reduce compressive patellofemoral loads and medialization shifts the pulling direction on the patella, thereby lowering the load on the lateral compartments.

Indications: Patellofemoral instability, patellofemoral malalignment, and distal and lateral chondral defects.

Technique description: The Multi-Directional Tibial Tubercle Transfer System (MD3T) uses a generic 3-dimensional cutting template to create 2 compound wedges that are individually transposed and adjusted to achieve multiplanar correction. For isolated tibial tubercle anteriorization, the primary wedge is solely used and the proximal bone defect is filled with autograft taken from the distal part of the wedge and synthetic bone graft substitution. For tibial tubercle medialization, the primary and secondary wedges are transposed, filling each other's respective spaces. Through the transposition of the primary and secondary wedges, partial filling of the defect with the patient's own bone is achieved, reducing the bone defect. For combined anteromedialization, both of these techniques are merged.

Results: During walking fatigue test and chair rising test in a cadaveric simulated 42-day healing period, no loosening or cracking occurred. Clinical study results on this technique are pending.

Conclusion: The MD3T system achieves with its wedge technique a precise and reproducible multiplanar correction in TTO.

Patient consent disclosure statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Keywords: MD3T; TTO; anteromedialization; patella; 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: A.B. received support for her salary from the grants of the Zaeslin Foundation (DMB2003), Martin Allgöwer Foundation, and AO Trauma Switzerland. S.L.S. receives consulting fees from Smith+Nephew, Inc., Linvatec Corporation, DJO LLC, Vericel Corporation, Flexion Therapeutics, Inc., Ceterix Orthopedics, Inc., Joint Restoration Foundation, Inc., Olympus America Inc., Bioventus LLC, LifeNet Health, Kinamed, Inc., and Pacira Therapeutics, Inc.; travel and lodging from Smith+Nephew, Inc., Linvatec Corporation, Vericel Corporation, Arthrex, Inc., Flexion Therapeutics, Inc., Joint Restoration Foundation, Inc., Aesculap Biologics, LLC, and Synthes GmbH; food and beverage from Smith+Nephew, Inc., Linvatec Corporation, Vericel Corporation, Arthrex, Inc., Joint Restoration Foundation, Inc., Aesculap Biologics, LLC, and Stryker Corporation; royalties or licenses from Linvatec Corporation, and CONMED Corporation; honoraria from Vericel Corporation, Flexion Therapeutics, Inc., and Joint Restoration Foundation, Inc.; educational support from Elite Orthopedics, LLC, and Evolution Surgical, Inc.; compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program, from Smith+Nephew, Inc., Vericel Corporation, and Arthrex, Inc.; compensation for serving as faculty or as a speaker for a nonaccredited and noncertified continuing education program from Linvatec Corporation; compensation for serving as faculty or as a speaker for an accredited or certified continuing education program from Synthes GmbH; received a grant from DJO LLC; has stock or stock options in Ostesys, Sarcio, Reparel, and Vivorte; is on design teams and receives royalties from CONMED Corporation and DJO LLC; is a paid advisory board member for Bioventus, Ostesys, Reparel, Sarcio, Sparta, Medical, Vericel, and Vivorte; is a paid educational consultant for Arthrex, Inc., DePuy, Flexion, JRF, Kinamed, Inc., LifeNet, NewClip, and Smith+Nephew, Inc.; is a course chair of ISMF and the PFF Masters Course; is a member of the AO Sports Medicine Taskforce; is on the editorial board for Arthroscopy, Current Reviews in Musculoskeletal Medicine, and Video Journal of Sports Medicine; and holds committee positions for Arthroscopy Association of North America, American Academy of Orthopedic Surgeons, ACL Study Group, AOSSM, Biologic Association, International Cartilage Regeneration & Joint Preservation Society, and International Society of Arthroscopy, Knee Surgery and Orthopedic Sports Medicine. 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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