I recently contributed to the Hospital for Special Surgery’s Grand Rounds, which shares complex cases and provides a great educational resource for knee surgeons. My contribution to the September issue was related to the diagnosis and treatment of an adolescent athlete who continued to have knee pain a year after she had undergone tibial tubercle osteotomy (TTO) combined with medial patellofemoral ligament (MPFL) reconstruction and particulated cartilage implant to the patella and trochlea. My case report walks through my initial exam and through the process we took (specifically a revision TTO) to enable her to achieve full range of motion and return to sport.
Although studies have shown TTOs to be effective for treating patellofemoral joint conditions, failures do occur, including delayed union and nonunion, which can potentially profoundly impact a patient’s quality of life. There is not a lot of literature available on the outcomes of revision surgery following a TTO, even though a nonunion following a TTO is a serious complication. Fortunately, experienced knee surgeons at HSS have been able to help patients undergoing revision TTO return to sports.
Read the complete case report in Grand Rounds from HSS: Management of Complex Cases.