A relatively rare operation as far as knee surgery goes is a distalizing tibial tubercle osteotomy. I do this surgery for patients who have patella alta or high knee caps. This can result in chronic anterior knee pain, fat pad impingement, patellar tendinitis and inferior patellar cartilage wear. It can also contribute to patellar instability in some patients.
The surgical treatment has historically been associated with significant complications such as fracture, delayed union or non-union or failure to unite. This modification of the technique is how I have been doing this surgery for the past 6-7 years and has resulted in a lot of satisfied patients.
The image shows lateral radiographs of the right knee from a 19-year-old female patient with patella alta and patellar instability who was indicated for tibial tubercle osteotomy with distalization.
Read more in Arthroscopy Techniques.