BACKGROUND: Anteromedialization of the tibial tuberosity has been shown to decrease mean total contact pressures of the lateral trochlea and to shift contact pressures to the medial trochlea. HYPOTHESIS: Modifying the anteromedialization osteotomy to a straight anteriorization osteotomy of the tibial tuberosity can decrease trochlear contact pressures without a resultant medial shift of forces to the medial trochlear contact area. STUDY DESIGN: Controlled laboratory study. METHODS: Ten cadavers were tested before and after straight anteriorization tibial tuberosity osteotomy by loading the extensor mechanism with 89.1 and 178.2 N at 0 degrees , 30 degrees , 60 degrees , and 90 degrees of flexion following a validated patellofemoral joint loading protocol. Contact pressures were measured with electroresistive pressure sensors placed directly on the trochlea. RESULTS: The mean trochlear contact pressures after osteotomy decreased significantly (P < .05) for loads of 89.1 and 178.2 N at both 30 degrees (23% and 20%, respectively) and 60 degrees (18.7% and 31.9%, respectively) of knee flexion. The peak contact pressures decreased significantly (P < .05) for loads of 89.1 and 178.2 N at 30 degrees (24.3% and 27.0%, respectively) and 60 degrees (31.9% and 24.5%, respectively) and for loads of 89.1 N at 90 degrees (13.4%) of knee flexion. CONCLUSION: The authors demonstrated significantly decreased trochlear contact forces after straight anteriorization osteotomy of the tibial tuberosity, without a significant resultant medial shift of the center of force. CLINICAL RELEVANCE: Straight anteriorization of the tibial tuberosity may be a useful adjunct for patients with medial articular defects of the patellar or trochlea in whom anteromedialization would be otherwise contraindicated.
BACKGROUND: Anteromedialization of the tibial tuberosity has been shown to decrease mean total contact pressures of the lateral trochlea and to shift contact pressures to the medial trochlea. HYPOTHESIS: Modifying the anteromedialization osteotomy to a straight anteriorization osteotomy of the tibial tuberosity can decrease trochlear contact pressures without a resultant medial shift of forces to the medial trochlear contact area. STUDY DESIGN: Controlled laboratory study. METHODS: Ten cadavers were tested before and after straight anteriorization tibial tuberosity osteotomy by loading the extensor mechanism with 89.1 and 178.2 N at 0 degrees , 30 degrees , 60 degrees , and 90 degrees of flexion following a validated patellofemoral joint loading protocol. Contact pressures were measured with electroresistive pressure sensors placed directly on the trochlea. RESULTS: The mean trochlear contact pressures after osteotomy decreased significantly (P < .05) for loads of 89.1 and 178.2 N at both 30 degrees (23% and 20%, respectively) and 60 degrees (18.7% and 31.9%, respectively) of knee flexion. The peak contact pressures decreased significantly (P < .05) for loads of 89.1 and 178.2 N at 30 degrees (24.3% and 27.0%, respectively) and 60 degrees (31.9% and 24.5%, respectively) and for loads of 89.1 N at 90 degrees (13.4%) of knee flexion. CONCLUSION: The authors demonstrated significantly decreased trochlear contact forces after straight anteriorization osteotomy of the tibial tuberosity, without a significant resultant medial shift of the center of force. CLINICAL RELEVANCE: Straight anteriorization of the tibial tuberosity may be a useful adjunct for patients with medial articular defects of the patellar or trochlea in whom anteromedialization would be otherwise contraindicated.
Authors: Archana Saranathan; Marcus S Kirkpatrick; Saandeep Mani; Laura G Smith; Andrew J Cosgarea; Juay Seng Tan; John J Elias Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-12-02 Impact factor: 4.342
Authors: Jacob G Calcei; Kunal Varshneya; Kyle R Sochacki; Marc R Safran; Geoffrey D Abrams; Seth L Sherman Journal: Cartilage Date: 2021-05-08 Impact factor: 3.117
Authors: Kyle R Sochacki; Kunal Varshneya; Jacob G Calcei; Marc R Safran; Geoffrey D Abrams; Joseph Donahue; Constance Chu; Seth L Sherman Journal: Cartilage Date: 2020-10-27 Impact factor: 3.117
Authors: Drew A Lansdown; David Christian; Brett Madden; Michael Redondo; Jack Farr; Brian J Cole; Adam B Yanke Journal: Cartilage Date: 2020-01-22 Impact factor: 3.117