Anteromedialization of the tibial tuberosity in the treatment of patellofemoral pain and malalignment.

In a retrospective clinical study of 25 knees in 22 patients treated for patellofemoral pain using the technique of Fulkerson in which anteriorization of the tibial tuberosity was combined with medialization, the results were evaluated at an average of 12 months and 30 months postoperatively. At the first evaluation, the results were satisfactory in 84%. In the follow-up period up to 38 months after surgery, this percentage decreased to 70%. The patients were placed in four groups based on preoperative roentgenographic findings. Only in the relatively young group of patients without signs of patellofemoral arthritis did the results remain satisfactory in all cases. At the late evaluation, there were satisfactory results in 60% of the patients with patellofemoral arthritis and/or lateralization. The rather extensive consolidation time and the long period of revalidation are disadvantages as are the difficulties with kneeling and hypoesthesia around the scar.