Tibial tubercle osteotomy

You may be a candidate for tibial tubercle osteotomy if you're dealing with ongoing kneecap alignment problems that affect your daily life. Common reasons include: 

• Recurrent patellar dislocation or subluxation
• Patellar maltracking or kneecap tracking disorder confirmed through imaging
• Patellofemoral instability that hasn't responded to physical therapy or bracing
• Anterior knee pain linked to patellar malalignment
• A history of patellar instability surgery that hasn't fully resolved symptoms
• Structural issues, such as an increased distance between the tibial tubercle and trochlear groove, that contribute to kneecap misalignment 

Your physician will review your symptoms, imaging and prior treatment history to determine whether tibial tubercle osteotomy is appropriate for you. 

Treatment for patellar instability and tracking problems depends on the severity of your symptoms and how they've responded to previous care. Options include: 

Nonsurgical

• Physical therapy focused on strengthening the muscles that support kneecap alignment
• Bracing or taping to help stabilize the kneecap during activity
• Activity modification to reduce stress on the knee

Surgical

• Medial patellofemoral ligament reconstruction, often used alone or alongside tibial tubercle osteotomy
• Tibial tubercle osteotomy, which repositions the tibial tubercle to correct alignment and reduce dislocation risk 

Your care team will discuss which combination of treatments makes sense for your specific pattern of instability. 

Recovery after tibial tubercle osteotomy takes time, and your care team will guide you through each phase. General milestones include: 

• Initial weeks focused on protecting the knee, managing swelling and gradually restoring range of motion
• A period of limited weight-bearing while the bone heals, guided by your surgeon's instructions
• Progressive physical therapy to rebuild strength, flexibility and stability around the knee
• Gradual return to daily activities, followed by a slower return to sports or high-impact movement
• Follow-up imaging to confirm healing before advancing your activity level 

Tibial tubercle osteotomy recovery time varies from patient to patient, and your surgeon will set expectations based on your specific procedure and healing progress.

As with any surgery, tibial tubercle osteotomy carries some risks, including infection, blood clots, stiffness or issues with bone healing. Some patients may experience continued instability or need additional treatment if symptoms don't fully resolve. These risks are uncommon, and your surgeon will walk you through what to expect, answer your questions and help you feel prepared before moving forward with treatment.