What is theTibial Tubercle?

The tibial tubercle is a lump at the top of the leg bone (tibia) where the patella ligament attaches. It is important in allowing the knee to straighten from a bent position (extension) as well as determining tracking of the kneecap (Patella).

Quadriceps MusclePatellar TendonTibial TubercleTibia (Shinbone)

What happens during a TTO?

During a TTO the tubercle is detached from the bone with a saw cut and moved to a new position and usually held in position to heal with screws.

The tubercle can be moved more towards the inner side of the knee (medial), more towards the ankle (distal) or more away from the bone (anterior) depending on the patient’s anatomy and the indications to perform the surgery.

What are the indications to perform a TTO

The main indications are

Intractable kneecap pain

Recurrent kneecap instability where it is often combined with a ligament reconstruction

For surgical exposure during complex knee replacement surgery

TTO to Realign the kneecap

TTO used during a complex Knee Replacement

What complications can occur from the surgery?

Complications are uncommon but can include

1
Loss of position of the osteotomy
2
Blood clots to the leg (DVT) or lungs (PE)
3
Persistent Bleeding
4
Knee stiffness
5
An unwanted fracture of the bone during or after the surgery
6
The osteotomy not healing
7
Loss of position of the osteotomy
8
Persistent pain after the surgery
9
Numbness around the scar as well as lower leg
10
Damage to the artery at the back of the leg
11
Compartment Syndrome

After Your Replacement Surgery background

What happens
after surgery?

After surgery your leg will be in a brace. You’ll be able to bear full weight on the leg limited by pain. The brace will allow progressively more bend at the knee over a period of 8 weeks. This surgery will require intense rehabilitation (see rehab protocols) and involves significant muscle wasting which can take 9-12 months to rehabilitate from.

Do you need a

Knee replacement?

Dr Seeto in affiliation with Medibank Private and East Sydney Private hospital, offers a program for eligible Medibank Private Members, to eliminate medical out of pocket costs for your Knee Replacement.

The program includes a pre-surgery preparation program, spending the minimal time necessary in hospital, as well as home rehabilitation if necessary.