Arthroscopy - Journal of Arthroscopic and Related Surgery
Arthroscopy - Journal of Arthroscopic and Related Surgery
4 years ago

Magnetic Resonance Imaging Validation of Tibial Tubercle Transfer Distance in the Fulkerson Osteotomy: A Clinical and Cadaveric Study

To validate the medialization and anteriorization distances, and the osteotomy angle of anteromedialization tibial tubercle osteotomies using postoperative axial imaging. Methods From March 2004 to August 2015, 117 consecutive patients who underwent anteromedialization osteotomies of the tibial tubercle by a single surgeon were identified. Only patients with pre- and postoperative magnetic resonance imaging (MRI) studies were included. Using MRI multiplanar reformats, distances that the tibial tubercle was translated medially (medialization) and anteriorly (anteriorization) were measured. In addition, the osteotomy angle was measured on the postoperative MRI. The measured values were compared with intraoperative estimates. Tibial tubercle osteotomies were then performed on 3 cadaveric knee specimens and imaged with pre- and postprocedure MRIs to correlate intraoperative measurements with MRI findings. Results A total of 40 patients (41 knees) (34.2%) had both pre- and postoperative MRIs and were included. Compared with intraoperative assessment, MRI measured medialization values average 94.7% (standard deviation [SD] 37.7) of dictated values (P = .1). MRI measured anteriorization averaged less than half of dictated values (48.9%, SD 18.2%, P < .0001). MRI measured osteotomy angles averaged 67.2% of dictated values (SD 50.3%, P < .0001). The steepest osteotomy angle that could be performed without violating the posterior cortex and/or endangering the posterior neurovascular structures was 46.3°. Conclusions Surgeons often overestimate both the anteriorization distance and the osteotomy angle in anteromedialization tibial tubercle osteotomies. The steepest osteotomy angle is less than the 60° described in the literature. Modifications should be considered when more anteriorization is desired with tubercle transfers. Level of Evidence Level IV, retrospective case series.

Publisher URL: www.sciencedirect.com/science

DOI: S0749806317307612

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.