FIELD: medicine.
SUBSTANCE: invention relates to traumatology and orthopaedics and can be used for transposition of tibial tuberosity (TT) in treating chronic lateral patellar instability. Before performing the operation, the MRI data are used to determine the distance between the centre of the intercondylar sulcus and the centre of the tibial tuberosity (TT-TG). Medial and lateral zones of the proposed osteotomy are marked with an electrocoagulator. Tibial osteotomy is performed for 5–7 cm, at depth of 1–1.5 cm in the direction from the inside to the outside at angle of 30° to the frontal plane. Distal part of the osteotomised tibia is sawn at an angle defined preoperatively; tibial tuberosity is medialized to reach the anatomical position of the patella. Tibial tuberosity is pre-fixed with two K-wires, range of motion in the knee joint, position and stability of the patella are checked; fixation is completed with 3.5 mm cortical screws with partial or full thread, or 4 mm or 4.5 mm compression screws. Correct position of the patella is confirmed by postoperative measurement of TT-TG, which should not exceed 15 mm.
EFFECT: method provides restoration of anatomical relationships in patellofemoral joint, optimization of patella tracking, reduced risk of postoperative complications due to increased contact of bone tissue of osteotomised tibial tuberosity in bone bed of tibia with medialization of tibial tuberosity.
1 cl, 4 dwg, 2 ex
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Authors
Dates
2024-04-02—Published
2023-04-11—Filed