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TRANSFER OF THE TIBIAL TUBEROSITY FOR A DISLOCATING KNEECAP

Method
Transfer of the tibial tuberosity (medialising, distalising or anteriorising)
Duration
about 60 to 90 minutes
Recovery time
3 to 6 months

Transfer of the tibial tuberosity is a well-established surgical procedure for treating a kneecap that dislocates repeatedly. The bony attachment of the patellar tendon (the tibial tuberosity) is moved on the shin bone so that the direction of pull on the kneecap is optimised. The aim is a stable track for the kneecap and the avoidance of further dislocations.

Depending on the type of deformity, the tuberosity can be moved medially (towards the middle), distally (downwards) or anteriorly (forwards). The operation is often combined with other procedures – for instance an MPFL reconstruction or a trochleoplasty.

What is a transfer of the tibial tuberosity?

Once the shin bone has been exposed, the tuberosity is carefully detached together with the tendon attachment and moved into the desired position. It is fixed with two titanium screws. The extent of the correction is planned precisely beforehand on the basis of imaging (for instance a CT scan with TT-TG measurement). The aim is to restore a natural track for the kneecap.

Temporary partial weight-bearing is necessary after the procedure so that the bone can heal reliably. Rehabilitation proceeds in close consultation between orthopaedic surgeon and physiotherapist.

Rehabilitation after a transfer of the tibial tuberosity

Aftercare following a transfer of the tibial tuberosity is structured in several phases and is guided by how the bone heals and by any procedures combined with it:

Phase I (0-6 weeks): protective phase
  • Partial weight-bearing with forearm crutches (15-20 kg)
  • Leg orthosis with extension limited according to the accompanying procedure
  • CPM splint and passive mobilisation to preserve movement
  • Cooling, elevation, lymphatic drainage
Phase II (6-12 weeks): building up load
  • Increasing the load up to full weight-bearing
  • Strengthening the quadriceps and the pelvic muscles
  • Functional training to restore the ability to walk
Phase III (from week 12): return to activity
  • Sport-specific build-up training
  • Co-ordination, balance, reaction
  • Return-to-activity testing (in competitive athletes)