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Three-dimensional transfer of the tibial tuberosity for patellar instability with patella alta.
[trochlear dysplasia]
Although
patellar
instability
can
be
treated
with
several
surgical
procedures
,
the
appropriate
surgical
treatment
for
patellar
instability
with
patella
alta
has
not
yet
been
investigated
.
The
objective
of
this
study
is
to
find
out
whether
three
-dimensional
transfer
of
the
tibial
tuberosity
elicits
good
knee
functionality
with
improved
patella
alta
and
prevents
further
patellar
dislocation
.
Twelve
knees
(
10
patients
)
underwent
surgery
for
patellar
instability
with
patella
alta
from
2007
to
2011
.
The
surgery
performed
was
a
three
-dimensional
transfer
for
the
anteromedial
distalization
of
the
tibial
tuberosity
.
Predisposing
anatomical
factors
for
patellar
instability
were
evaluated
preoperatively
;
femorotibial
angle
(
FTA
)
,
patella
alta
(
IS
ratio
)
,
trochlear
dysplasia
(
sulcus
angle
)
and
tilting
angle
(
lateral
tilt
)
.
The
function
of
the
knee
was
assessed
before
and
after
surgery
by
Lysholm
and
Kujala
score
.
Before
surgery
,
the
IS
ratio
was
1
.
34
Â
±
Â
0
.
13
,
lateral
tilt
was
22
.
4
°
Â
±
Â
6
.
5
°
,
and
the
sulcus
angle
was
151
.
7
°
Â
±
Â
8
.
3
°
,
indicating
patella
alta
,
laterality
,
and
trochlear
dysplasia
.
After
surgery
,
the
IS
ratio
and
lateral
tilt
significantly
improved
to
0
.
95
Â
±
Â
0
.
13
,
and
10
.
6
°
Â
±
Â
3
.
4
°
,
respectively
.
FTA
and
sulcus
angle
were
not
altered
.
Lysholm
and
Kujala
score
improved
from
63
.
8
to
94
.
7
and
67
.
0
to
94
.
1
points
,
respectively
.
Most
patients
displayed
good
outcomes
except
for
one
patient
who
suffered
re
-
dislocation
by
hitting
their
knee
on
the
floor
,
2
.
5
Â
years
after
surgery
.
Three
-dimensional
tibial
tuberosity
transfer
was
shown
to
correct
the
patella
position
and
result
in
a
good
clinical
outcome
.
This
method
is
introduced
as
an
alternative
surgery
for
patellar
instability
with
patella
alta
.
Diseases
Validation
Diseases presenting
"2"
symptom
22q11.2 deletion syndrome
cushing syndrome
epidermolysis bullosa simplex
erythropoietic protoporphyria
krabbe disease
monosomy 21
pendred syndrome
thoracic outlet syndrome
trochlear dysplasia
werner syndrome
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